Clinical Edge

Summaries of Must-Read Clinical Literature, Guidelines, and FDA Actions

Treatment Outcomes Post-Surgery for Moyamoya Disease

J Neurol; ePub 2018 Sep 8; Kahn, Kaur, Stein, et al

Although readmission after revascularization surgery (RS) for moyamoya disease (MMD) is not uncommon, cerebral hemorrhagic events during the 90-day postoperative period are rare, according to a recent analysis of nationally representative US data. In the Nationwide Readmissions Database, index admissions for MMD and readmissions for ischemic stroke (IS), subarachnoid hemorrhage (SAH), and intracerebral hemorrhage (ICH) were identified. Researchers summarized demographics and comorbidities, and calculated 30-, 60-, and 90-day readmission rates per 100,000 index admissions. They found:

  • Among 201 index admissions for RS for MMD, mean age (SD) was 41.7 (12.6) years; 75% were female; 24% had diabetes; 53% had hypertension; 40% had hypercholesterolemia; 3% had ICH; 16% had IS; and 1% had SAH.
  • RS was performed at large hospitals in 83%, urban hospitals in 85%, and teaching hospitals in 97%.
  • 80% were discharged home; 34% had a readmission during follow-up.
  • Leading reasons for readmission up to 90 days included MMD (62%), postoperative infection (10%), sickle cell crisis (4%), ischemic stroke (4%), epilepsy (2%), subdural hemorrhage (2%) and headache (2%).

Citation:

Kahn A, Kaur G, Stein L, Tuhrim S, Dhammon MS. Treatment course and outcomes after revascularization surgery for moyamoya disease in adults. [Published online ahead of print September 8, 2018]. J Neurol. doi: 10.1007/s00415-018-9044-z.

This Week's Must Reads

Global Burden of Brain and Other CNS Cancers, Lancet Neurol; ePub 2019 Feb 20; GBD 2016 Brain and Other CNS Cancer Collaborators

Ethnoracial Differences Found in Alzheimer Disease, Alzheimers Dement; ePub 2019 Feb 18; Santosa, et al

Artificially Sweetened Beverages and Stroke in Women, Stroke; ePub 2019 Feb 14; Mossavar-Rahmani, et al

Must Reads in Rare Diseases

Treatment Outcomes Post-Surgery for Moyamoya Disease, J Neurol; ePub 2018 Sep 8; Kahn, Kaur, Stein, et al

FDA Approves Hizentra for CIDP Treatment, CSL Behring news release; 2018 Mar 16

Cerebral Cavernous Malformation in the Elderly , JAMA Neurol; ePub 2017 May 8; Flemming, et al