Abstract TMP91: Healthcare Utilization For Headache And Anxiety After Surgical Revascularization In Children With Moyamoya Vasculopathy

Abstract

Introduction: Headache and anxiety are poorly described in children with moyamoya vasculopathy following revascularization. Hypothesis: Headache and anxiety in pediatric moyamoya patients are common co-morbidities and result in frequent healthcare utilization. Methods: In this single-center retrospective cohort study, children (<18 years of age) with moyamoya syndrome or disease who underwent EC-IC bypass between 2007-2020 were identified from a UCSF registry. Data regarding headache or anxiety were abstracted from medical records of inpatient, outpatient and emergency (ED) encounters using standardized forms. ED encounters were attributed to headache or anxiety when they occurred in the absence of stroke or TIA and documented as the likely cause of symptoms for that visit. Summary statistics were used to describe outcomes. Results: We identified 32 children (63% female, 53% white, 22% Hispanic) who underwent initial revascularization surgery at a median age of 8.3 years (range 0.8-17.4). Two or more EC-IC surgeries were completed in 84% of patients. During follow-up after surgery (median 6.7 years, interquartile range 3.2 - 8.2 years), 81% of patients reported headache and 53% reported anxiety (Table). Headaches led to 27 ED encounters among 10 patients (31%). Headache rescue medications were prescribed to 21 patients (66%), and headache prophylaxis was prescribed in 37.5%. Six patients (19%) were referred to a headache specialist. Symptoms attributed to anxiety led to six ED encounters among three patients, and 19% (6/32) reported panic attacks. A referral to mental health services was provided to 44% (14/32) of patients. Conclusions: Headaches and anxiety are common symptoms among children with moyamoya after revascularization and may lead to significant healthcare consumption. Symptoms and prevention measures should be explored in future studies to improve quality of life and decrease healthcare utilization.