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Abstract Details

Transcranial Doppler Vasomotor Reactivity Findings in Moyamoya Disease
Cerebrovascular Disease and Interventional Neurology
Cerebrovascular Disease and Interventional Neurology Posters (7:00 AM-5:00 PM)
260
We aim to compare carbon dioxide (CO2) challenge to breath holding index (BHI) in transcranial doppler (TCD) vasomotor reactivity (VMR) studies to identify which method better correlated with symptomatic vasculopathy and affected cerebral hemisphere in Moya Moya disease. 
TCD VMR studies can assist as an indirect method of assessing cerebral autoregulation after a vasodilatory stimulus. 
We retrospectively analyzed patients with concern for cerebral vasculopathy from idiopathic Moyamoya disease or Moyamoya syndrome (i.e. “secondary” Moyamoya) specifically analyzing those patients who initially had baseline VMR conducted with either BHI or CO2 challenge, or both. Baseline demographic data was collected and VMR studies were analyzed to assess the correlation between CO2 challenge or BHI results and ability to identify areas of symptomatic vasculopathy and affected cerebral hemisphere.
From a total of 61 Moyamoya patients, 44 patients had either CO2 or BHI VMR. Regarding patient demographics, mean age was 44±16 years-old, 30 (73%) were female, 18 (43%) had hypertension, 8 (20%) had diabetes mellitus type 2, and 13 (31%) had dyslipidemia. The mean VMR in the asymptomatic hemisphere was 58 ±22% and in the symptomatic hemisphere was 34±22% (p<0.0001). The mean BHI in the asymptomatic hemisphere was 0.78 ± 0.51 and in the symptomatic hemisphere was 0.35 ±0.51. A total of 57 hemispheres were available for CO2 challenge and 46 hemispheres were available for BHI to assess the correlation between the symptomatic hemisphere and VMR studies. An event tree analysis (ETA) was calculated to correlate VMR and BHI with the symptomatic hemisphere. For VMR, the ETA was 0.41 and for BHI it was 0.39 suggesting moderate and similar correlation for both measures to assess the symptomatic hemisphere.
Transcranial doppler VMR studies are a reasonable, non-invasive method for identifying symptomatic or affected cerebral hemispheres in Moyamoya, with similar correlation between CO2 challenge vs BHI studies. 
Authors/Disclosures
Sishir Mannava, MD (UT Health)
PRESENTER 		Dr. Mannava has nothing to disclose.
Whitney E. Mayberry, MD (Jackson Memorial Hospital) Dr. Mayberry has nothing to disclose.
Amer Malik, MD (University of Miami Miller School of Medicine) Dr. Malik has nothing to disclose.
Sebastian Koch, MD (University of Miami) Dr. Koch has received personal compensation in the range of $10,000-$49,999 for serving as an Expert Witness for Multiple Legal Matters. Dr. Koch has received stock or an ownership interest from Cerepeutics. Dr. Koch has received intellectual property interests from a discovery or technology relating to health care. Dr. Koch has received intellectual property interests from a discovery or technology relating to health care.