Document Detail

Characterization of cortical microvascularization in adult moyamoya disease.
MedLine Citation:
PMID:  18403740     Owner:  NLM     Status:  MEDLINE    
BACKGROUND AND PURPOSE: Increased cortical microvascularization has been proposed to be a Moyamoya disease (MMD)-specific characteristic. It was the aim of our study to characterize the anatomic pattern and microhemodynamics of cortical microvascularization in MMD. METHODS: Intraoperative indocyanine green videoangiography was performed in 16 adult MMD patients, 15 patients with atherosclerotic cerebrovascular disease (ACVD), and 10 control patients. Cortical microvascularization and microvascular hemodynamics were categorized and analyzed according to anatomic and functional indocyanine green angiographic aspects. Anatomic analysis included microvascular density, microvascular diameter, and microvascular surface per analyzed area. Microhemodynamic analysis included microvascular transit time, arterial microvascular transit time, and venous microvascular transit time. RESULTS: Microvascular density and diameter were significantly increased in MMD patients (1.8+/-0.2 mm/mm(2) and 0.24+/-0.03 mm, respectively) compared with those in ACVD patients (1.5+/-0.2 mm/mm(2) and 0.20+/-0.02 mm, respectively) and controls (1.5+/-0.1 mm/mm(2) and 0.19+/-0.03 mm, respectively). This resulted in significantly increased microvascular surface per analyzed area in MMD (67+/-13%) vs ACVD patients (47+/-7%) and controls (45+/-6%). Anatomic changes were paralleled by significantly increased microvascular and arterial microvascular transit times in MMD patients (11.55+/-3.50 and 6.79+/-2.96 seconds, respectively) compared with those in ACVD patients (8.13+/-1.78 and 4.34+/-1.30 seconds, respectively) and controls (8.04+/-2.16 and 4.50+/-1.87 seconds, respectively). CONCLUSIONS: Cortical microvascularization in MMD is characterized by significantly increased microvascular density and microvascular diameter, leading to increased microvascular surface. These anatomic alterations are accompanied by prolonged microvascular hemodynamics. These observations might represent an MMD-specific compensation mechanism for impaired cerebral blood flow.
Marcus Czabanka; Pablo Peña-Tapia; Gerrit A Schubert; Johannes Woitzik; Peter Vajkoczy; Peter Schmiedek
Publication Detail:
Type:  Journal Article     Date:  2008-04-10
Journal Detail:
Title:  Stroke; a journal of cerebral circulation     Volume:  39     ISSN:  1524-4628     ISO Abbreviation:  Stroke     Publication Date:  2008 Jun 
Date Detail:
Created Date:  2008-05-28     Completed Date:  2008-07-03     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  0235266     Medline TA:  Stroke     Country:  United States    
Other Details:
Languages:  eng     Pagination:  1703-9     Citation Subset:  IM    
Department of Neurosurgery, Charité-Universitätsmedizin Berlin, Campus Virchow Klinikum, Am Augustenburgerplatz 1, 13353 Berlin, Germany.
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MeSH Terms
Age Factors
Cerebral Angiography
Cerebral Arteries / pathology*,  physiopathology*
Cerebral Cortex / blood supply,  pathology,  physiopathology
Cerebral Veins / pathology,  physiopathology
Cerebrovascular Circulation
Indicators and Reagents
Indocyanine Green
Microcirculation / pathology*,  physiopathology*
Middle Aged
Moyamoya Disease / pathology*,  physiopathology*
Time Factors
Videotape Recording
Reg. No./Substance:
0/Indicators and Reagents; 3599-32-4/Indocyanine Green

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