Functional and Neuropsychological Outcome After Surgical Treatment of Moyamoya Disease

Abstract

IntroductionMoya Moya disease(MMD) is a rare cerebrovascular disease characterized by progressive stenosis of the supraclinoid ICA. Due to chronically decreased brain perfusion, eloquent areas of the brain become hypo-perfused leading to cognitive changes in patients. Repeated infarcts and bleeds produce clinically apparent neurological deficits. Aim and Objective1) To study the functional and neuropsychological outcome in Moya Moya Disease following revascularization surgery.2) To find post revascularisation correlation between functional and neuropsychological improvement and radiological improvement. Material and methodA single-center prospective and analytical study including 21 patients of MMD during the study period from March 2021 to December 2022. Patients were evaluated and compared in the pre-and post-revascularization for functional, neuropsychological, and radiological status. ResultPost-operative functional outcome in terms of modified Rankin Score showed improvement in 33.33% of cases (p-value = 0.0769). An overall improving trend was observed in different neuropsychological domains in both adult and pediatric age groups. But, the trend of neuropsychological improvement was better in adults as compared to the pediatric patients. Radiological outcome in the forms of the Angiographic Outcome Score (AOS) significantly improved after post-revascularization (p-value = 0.0001). There was a trend towards improvement in MRI perfusion in the MCA and ACA territories, 4.7% (p-value=0.075) and 9.33% (p-value-0.058) respectively, as compared to preoperative MRI perfusion. ConclusionsPost revascularisation, significant improvement occurred in functional and neuropsychological status. This was also demonstrated radiologically as evident by improvement in MRI perfusion and cerebral angiography.