Is medical management useful in Moyamoya disease?  

作　　者：Sombat Muengtaweepongsa Vatcharasorn Panpattanakul 

机构地区：[1]Center of Excellence in Stroke,Division of Neurology,Department of Medicine,Faculty of Medicine,Thammasat University,Rangsit Campus,Klonglaung 12120,Pathum Thani,Thailand [2]Division of Neurology,Department of Internal Medicine,School of Medicine,University of Phayao,Phayao 56000,Thailand

出　　处：《World Journal of Clinical Cases》2024年第3期466-473,共8页世界临床病例杂志

摘　　要：Moyamoya disease(MMD),characterized by progressive internal carotid artery stenosis and collateral vessel formation,prompts cerebral perfusion complications and is stratified into idiopathic and Moyamoya syndrome subtypes.A multifa-ceted approach toward MMD management addresses cerebral infarctions through revascularization surgery and adjunctive medical therapy,while also navigating risks such as intracranial hemorrhage and cerebral infarction resulting from arte-rial stenosis and fragile collateral vessels.Addressing antithrombotic management reveals a potential role for treatments like antiplatelet agents and anticoagulants,despite the ambiguous contribution of thrombosis to MMD-related infarctions and the critical balance between preventing ischemic events and averting hemo-rrhagic complications.Transcranial doppler has proven useful in thromboembolic detection,despite persisting challenges concerning the efficacy and safety of an-tithrombotic treatments.Furthermore,antihypertensive interventions aim to ma-nage blood pressure meticulously,especially during intracerebral hemorrhage,with recommendations and protocols varying based on the patient’s hypertension status.Additionally,lipid-lowering therapeutic strategies,particularly employing statins,are appraised for their possible beneficial role in MMD management,even as comprehensive data from disease-specific clinical trials remains elusive.Com-prehensive guidelines and protocols to navigate the multifaceted therapeutic ave-nues for MMD,while maintaining a delicate balance between efficacy and safety,warrant further meticulous research and development.This protocol manuscript seeks to elucidate the various aspects and challenges imbued in managing and navigating through the complex landscape of MMD treatment.

关 键 词：Moyamoya disease Cerebral infarction Antithrombotic management Transcranial doppler REVASCULARIZATION Intracerebral hemorrhage Antihypertensive intervention Lipid-lowering therapies 

分 类 号：R743[医药卫生—神经病学与精神病学]