Case-Control Study of Cephalometrics in Patients with Moyamoya

World Neurosurg. 2019 Oct:130:e831-e838. doi: 10.1016/j.wneu.2019.06.233. Epub 2019 Jul 9.

Abstract

Objective: To determine whether cranial metrics consistently differed between patients with moyamoya and age-, sex-, and race-matched controls.

Methods: Patients diagnosed with moyamoya disease by cerebral angiogram were obtained from a prospectively collected database through the Department of Neurosurgery at the University of Kansas Medical Center. Control patients matched by decade of age, sex, and race were collected through a deidentified hospital database by International Classification of Diseases-9 and 10 codes for ischemic stroke to identify patients with computed tomography angiograms. Imaging studies for both groups were analyzed to obtain 6 skull metrics: maximum anterior to posterior distance, maximum biparietal distance, bregma to occiput distance, right carotid canal diameter (CCD), left CCD, and cephalic index.

Results: Forty-five patients were identified in each cohort. Measurements of mean anterior to posterior skull diameter, mean biparietal skull diameter, bregma to occiput distances, and calculated cephalic index did not demonstrate a statistically significant difference between patients with moyamoya and control patients. Right carotid canal mean diameter was 4.8 mm for the moyamoya group and 5.4 mm for the control group, with a significant raw mean difference of -0.61 mm (95% confidence interval, -0.95 to -0.27). Left CCD was 4.7 mm for the moyamoya group and 5.5 mm for the control group, resulting in a significant raw mean difference of -0.76 mm (95% confidence interval, -1.09 to -0.43).

Conclusions: This study identified 2 skull parameters as statistically different in patients with moyamoya compared with a matched control group of patients with ischemic stroke: right CCD and left CCD.

Keywords: Carotid canal; Cephalometric; Ischemic stroke; Moyamoya; Skull.

MeSH terms

  • Adolescent
  • Adult
  • Aged
  • Aged, 80 and over
  • Case-Control Studies
  • Cephalometry / methods*
  • Cephalometry / standards
  • Cohort Studies
  • Female
  • Humans
  • Male
  • Middle Aged
  • Moyamoya Disease / diagnostic imaging*
  • Prospective Studies
  • Young Adult