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Determinants of intellectual outcome after surgical revascularization in pediatric moyamoya disease: a multivariate analysis

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Abstract

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.

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Authors and Affiliations

  1. Department of Neurosurgery, Hokkaido University Graduate School of Medicine, North 15 West 7, Kita-ku, Sapporo 060-8638, Japan

    Satoshi Kuroda, Kiyohiro Houkin, Tatsuya Ishikawa, Naoki Nakayama, Jun Ikeda, Nobuaki Ishii, Hiroyasu Kamiyama & Yoshinobu Iwasaki

Authors
  1. Satoshi Kuroda
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  2. Kiyohiro Houkin
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  3. Tatsuya Ishikawa
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  4. Naoki Nakayama
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  5. Jun Ikeda
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  6. Nobuaki Ishii
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  7. Hiroyasu Kamiyama
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  8. Yoshinobu Iwasaki
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Correspondence to Satoshi Kuroda.

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Kuroda, S., Houkin, K., Ishikawa, T. et al. Determinants of intellectual outcome after surgical revascularization in pediatric moyamoya disease: a multivariate analysis. Childs Nerv Syst 20, 302–308 (2004). https://doi.org/10.1007/s00381-004-0924-4

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  • DOI: https://doi.org/10.1007/s00381-004-0924-4

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