Efficacy of encephalo - duro - arterio - synangiosis in adult moyamoya disease

Objective To determine the clinical features and the efficacy of encephalo - duro -arterio - synangiosis( EDAS) in adult Moyamoya disease( MMD). Method 312 patients with adult MMD admitted to our hospital from December 2002 to September 2008 were retrospectively reviewed. All patients were underwent EDAS and followed up for a 26 - month mean period. Results The initial symptom was cerebral ischemia in 249 patients ( 79. 8% ) and cerebral hemorrhage in 63 patients ( 20. 2% ) . After operation,2 cases in 63 patients with hemorrhage had rebleeding and one died,and 219 cases in 249 patients with ischemia had relief obviously. PET examinations showed post - operative glucose metabolism was increased clearly in 157 of 206 hemispheres (76. 2% ). DSA examinations revealed a good revascularization on 47 of 83 hemispheres (56. 6% ) after operation. Multivariate logistic regression analysis showed that hypometabolism,youngers and ischemic type indicated better revascularization. Conclusions Adult patients in China with Moyamoya disease present with different clinical features compared with other countries. Surgical treatment with EDAS seems to be effective in adult MMD in terms of clinical improvement. Key words: Moyamoya disease;  Encephalo - duro - arterio - synangiosis;  Adult