Background
White matter lesions (WMLs) indicate progressive cerebral small vessel disease and
are frequently observed in aging people and stroke patients. The purpose of this study
was to evaluate WMLs and the influence of revascularization surgery for WMLs in patients
with moyamoya disease.
Methods
A total of 42 hemispheres in 21 patients with moyamoya disease were included in this
analysis. WMLs were detected on fluid-attenuated inversion recovery (FLAIR) imaging
in 24 hemispheres. The distribution pattern of WMLs was categorized. WMLs were measured
by manually creating a region of interest, and the total WML volume in the hemisphere
was estimated and compared with the control group. Clinical features of patients with
WMLs and postoperative changes were analyzed.
Results
The total WML volume in moyamoya disease was significantly higher than that of controls
(P = .014). WMLs were observed in the internal watershed zone, especially in the watershed
zone between the anterior cerebral artery and the middle cerebral artery. Patients
with WMLs had significantly higher magnetic resonance angiography scores compared
with controls (P = .015). A given patient's total WML volume per hemisphere was significantly decreased
after surgery (P = .001).
Conclusions
WMLs on FLAIR imaging increase in patients with moyamoya disease and are reversible
by revascularization surgery. Improvement of cerebral blood flow is partly related
to the decrease in WMLs. The present results provide insight into the potential role
of revascularization surgery.
Key Words
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Article info
Publication history
Published online: March 30, 2016
Accepted:
February 25,
2016
Received in revised form:
February 9,
2016
Received:
December 25,
2015
Identification
DOI: https://doi.org/10.1016/j.jstrokecerebrovasdis.2016.02.035
Copyright
© 2016 National Stroke Association. Published by Elsevier Inc. All rights reserved.
