Analysis of Risk Factors for the Occurrence of Rebleeding Following Surgery for Hemorrhagic Moyamoya Disease.

OBJECTIVE

To investigate the clinical characteristics and factors influencing the occurrence of rebleeding following cerebral revascularization surgery in adult patients with hemorrhagic moyamoya disease (MMD).

METHODS

Clinical data were collected from patients diagnosed with hemorrhagic MMD who underwent superficial temporal artery-middle cerebral artery bypass grafting combined with cerebral-dural-temporal muscle patching. Seventy-five patients meeting the inclusion criteria were followed up and categorized into rebleeding and non-rebleeding groups. Their clinical data were comparatively analyzed.

RESULTS

Of the 75 patients (32 men, 43 women; mean age 46.8 ± 5.1 years), 12 experienced postoperative rebleeding. The age of onset was significantly lower in the rebleeding group (t = 4.165, P = 0.045). Hypertension was more prevalent in the rebleeding group (83.3%) than in the non-rebleeding group (47.7%) (χ2 = 15.166, P = 0.023). Ventricular hemorrhage was more frequent in the rebleeding group (χ2 = 4.018, P = 0.045). Significant differences were also observed in Suzuki stages III and V (χ2 = 4.018, P = 0.045; χ2 = 7.717, P = 0.005, respectively). Postoperative blood pressure control and the presence of aneurysms were more common in the rebleeding group (χ2 = 10.595, P = 0.001; χ2 = 5.969, P = 0.015, respectively).

CONCLUSIONS

The study identified significant differences in the age of onset, history of hypertension, postoperative blood pressure control, ventricular hemorrhage, Suzuki stages (III and V), and the presence of aneurysms between the rebleeding and non-rebleeding groups of patients with hemorrhagic MMD.