Publication: Functional outcome post direct bypass in adult moyamoya disease: A local study
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Date
2022
Authors
Shab, Mas Syazaneeza
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Abstract
Background: Bypass surgery has been the mainstay of treatment for Moyamoya Disease in both adult and paediatric populations. This surgery is relatively new and emerging number of studies are being done to established the outcome of this bypass procedure. The aim of this study is to assess the functional outcome of direct bypass surgery in adult populations in local setting, as well as improvement in cerebral perfusion and to analyse the demographic and clinical presentation in local setting. Methods: 13 adult patients who underwent direct bypass surgery for MMD in Hospital Kuala Lumpur from December 2017 to December 2021 are identified from operation theatre record. Each of patient’s medical record was then traced. Patients’ demographic data was identified and categorized by age, gender, race, comorbidities and laterality of disease. Clinical presentation for each patient is also determined. Pre and post-operative functional outcome were assigned according to Modified Rankin Scale Score. Radiological outcome post-operative were assessed using Computed Tomography Cerebral Perfusion as well as patency of bypass. Any complication following procedure is also identified. Results: 53.8% of patients has unilateral presentation of MMD. 23% has improvement in functional outcome, while the remaining 77% who underwent direct bypass procedure has static functional outcome. None has deterioration in function, and none developed new episode of stroke. There is improvement in cerebral perfusion parameters post-surgery, however we failed to achieve a statistically significant data.Conclusion: Based on our study, adult patients with MMD who underwent direct bypass surgery has either static or improvement in functional outcome and manage to prevent future recurrent stroke, with an increment in cerebral perfusion. However in view of our study limitation, a longer duration of study is suggested in order to gain a higher sample size in view of the rarity of disease in Malaysia in order to gain a better understanding of the disease
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Keywords
Moyamoya Disease , Modified Rankin Scale Score