Clinical features and predictive factors of cerebral hyperperfusion syndrome after cerebrovascular reconstruction in moyamoya disease

Abstract

Objective To summarize the clinical features of cerebral hyperperfusion syndrome (CHS) after cerebrovascular reconstruction for moyamoya disease (MMD), and to screen its related predictive factors. Methods The clinical data of 50 patients with MMD who underwent cerebrovascular reconstruction in the Second Affiliated Hospital of Nanchang University from June 2017 to December 2018 were collected, including sex, age, history of hypertension, disease type, preoperative Suzuki stage, surgery side, mean arterial pressure (MAP) before and after surgery, time from surgery to onset of CHS, clinical manifestations, duration of symptoms, and postoperative hospital stay. Univariate and multivariate Logistic regression analysis were used to screen the related predictors of CHS after cerebrovascular reconstruction for MMD. Spearman rank correlation analysis to explore the correlation between time from surgery to symptom onset and duration of symptoms. Results Among the 50 patients, 13 patients (26%) developed CHS after surgery. Logistic regression analysis showed that over age (OR=0.867, 95%CI: 0.790-0.953; P=0.003) and left⁃side surgery (OR=0.158, 95%CI: 0.029-0.863; P=0.033) was predictor of postoperative CHS in patients with MMD. Spearman rank correlation analysis showed that the time from surgery to symptom onset was negatively correlated with duration of symptom in patients with CHS (r_s=⁃0.925, P=0.000). Conclusions CHS is a self⁃limiting complication after cerebrovascular reconstruction for MMD. Higher age and left⁃sided surgery are clinical predictive factors of postoperative CHS.

doi：10.3969/j.issn.1672⁃6731.2022.05.008