Document Detail

Determinants of intellectual outcome after surgical revascularization in pediatric moyamoya disease: a multivariate analysis.
MedLine Citation:
PMID:  15045517     Owner:  NLM     Status:  MEDLINE    
OBJECTS: The aim of this study was to clarify predictors for poor intellectual outcome in pediatric moyamoya disease. METHODS: Fifty-two pediatric patients were included. Clinical diagnosis was transient ischemic attacks (TIA) in 35 and completed stroke in 17. Ten patients underwent indirect synangiosis through "small craniotomy," whereas the other 42 underwent superficial temporal artery (STA)-middle cerebral artery (MCA) anastomosis and indirect synangiosis through "large craniotomy." Full-scale IQ (FSIQ) was measured using the Wechsler intelligence scale for children (WISC) after surgery. Multivariate logistic regression models were applied to test the effect of clinical factors on intellectual outcome. RESULTS AND CONCLUSION: Eight patients revealed mentally impaired status (FSIQ<70). Multivariate analysis revealed that completed stroke and "small craniotomy" surgery were significantly associated with poor intellectual outcome. Odds ratios of each factor were 33.4 (95% CI, 2.4-474) and 19.6 (95% CI, 1.8-215) respectively. Early diagnosis and the revascularization procedure over as wide an area as possible may be essential to improve their intellectual outcome.
Satoshi Kuroda; Kiyohiro Houkin; Tatsuya Ishikawa; Naoki Nakayama; Jun Ikeda; Nobuaki Ishii; Hiroyasu Kamiyama; Yoshinobu Iwasaki
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Publication Detail:
Type:  Journal Article     Date:  2004-03-24
Journal Detail:
Title:  Child's nervous system : ChNS : official journal of the International Society for Pediatric Neurosurgery     Volume:  20     ISSN:  0256-7040     ISO Abbreviation:  Childs Nerv Syst     Publication Date:  2004 May 
Date Detail:
Created Date:  2004-06-01     Completed Date:  2004-08-17     Revised Date:  2007-11-15    
Medline Journal Info:
Nlm Unique ID:  8503227     Medline TA:  Childs Nerv Syst     Country:  Germany    
Other Details:
Languages:  eng     Pagination:  302-8     Citation Subset:  IM    
Department of Neurosurgery, Hokkaido University Graduate School of Medicine, North 15 West 7, Kita-ku, Sapporo 060-8638, Japan.
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MeSH Terms
Cerebral Revascularization / methods*
Cerebrovascular Circulation
Child, Preschool
Confidence Intervals
Craniotomy / methods
Follow-Up Studies
Frontal Lobe / blood supply,  radionuclide imaging
Moyamoya Disease / complications,  physiopathology,  psychology*,  surgery*
Multivariate Analysis
Odds Ratio
Postoperative Period
Stroke / etiology
Tomography, Emission-Computed
Treatment Outcome
Wechsler Scales

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