Analysis of risk factors for the occurrence of rebleeding following surgery for haemorrhagic moyamoya disease.

Abstract

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

Methods: Clinical data were collected from patients diagnosed with haemorrhagic 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 categorised into rebleeding and non-rebleeding groups. Their clinical data were comparatively analysed.

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 haemorrhage 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).

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