Moyamoya and ethnic diversity
Irshad K, Schultz L, Zahoor S, and Malik S. Moyamoya and ethnic diversity. Neurology 2017; 88(16 Suppl 1).
Objective: To review cases of moyamoya syndrome (MMS) presenting to a single tertiary care center in North America. Background: The number of patients identified with MMS in the US has risen dramatically in the last two decades. Differences in presenting symptoms, sex, race and age distribution exist between Asian and North American populations. Etiology of MMS in ethnically diverse cohorts especially African Americans (AA) is not fully understood. Design/Methods: Retrospective analysis of patients presenting to our institution from 1995 to 2016 was performed. ICD9 and ICD10 codes for moyamoya disease and MMS were confirmed through electronic medical record review. Descriptive statistics were computed using SAS 9.4. We reviewed 252 patients, 181 were excluded due to diagnosis of aneurysm, stroke, or other conditions. Chart review was conducted on patients with confirmed moyamoya. Age, gender, race, presenting symptoms, prevalence of known cerebrovascular risk factors, and associated conditions were evaluated. Results: A total of 71 cases were confirmed to have moyamoya. Out of these, 70% were female, 44% Caucasian and 39% AA. Mean age of onset was 34.4 years with most patients (26%) in the age group 30-39. The most common symptoms were unilateral weakness (23%) followed by speech deficits and ischemic stroke (17% each), and seizures and TIA (15% each). Most common risk factor was HTN (47%), followed by smoking (41%) and HLD (35%). Treatments were medical management only (41%) and surgical interventions (31%). Four patients had Down's syndrome and 10 patients had autoimmune conditions (7 with thyroid disease) which are known to be associated with MMS. Conclusions: Our study showed significant proportion of AA patients compared to other cohorts studied in the US. With the rise in MMS in different ethnicities in the US, further studies need to be conducted to get a better understanding of causes within these populations.
16 Suppl 1