ArticleJournal of stroke and cerebrovascular diseases : the official journal of National Stroke Association2024
Relative anemia and perioperative stroke in children with moyamoya.
Article in Journal of stroke and cerebrovascular diseases : the official journal of National Stroke Association, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 5 papers.
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Who cites it
5 citing papers in PubMed, 2 citations in OpenAlex.
- Thalamic anastomosis as a potential marker of perioperative ischemic risk in moyamoya disease.Neurosurgical review · 2026Article
- Association of high-sensitivity C-reactive protein-to-hemoglobin ratio with stroke risk: A study based on the China Health and Retirement Longitudinal Study and English Longitudinal Study of Ageing cohorts.The Journal of international medical research · 2026Article
- Intraoperative Diabetes Insipidus as a Predictor of Postoperative Complications Following Revascularization in Moyamoya Disease: A Retrospective Cohort Study.Current neurovascular research · 2026Article
- Letters to editor regarding the article "Outcomes of surgical revascularization for pediatric moyamoya disease and syndrome".Child's nervous system : ChNS : official journal of the International Society for Pediatric Neurosurgery · 2025Article
- Crosstalk: Biochemical Signatures and Clinical Implications in Rare Hereditary Hemolytic Anemias (Hereditary Spherocytosis).Current pharmaceutical design · 2025Article
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Authors and funding
9 authors at 3 institutions in 1 country.
Funding
Abstract
objectivesSurgical revascularization for moyamoya arteriopathy decreases long-term stroke risk but carries a risk of perioperative ischemic complications. We aimed to evaluate modifiable stroke risk factors in children undergoing surgical revascularization for moyamoya. MATERIALS AND
methodsIn this exploratory, single-center, retrospective cohort study, medical records of pediatric patients undergoing surgical revascularization for moyamoya arteriopathy at our center between 2003 and 2021 were reviewed. Candidate modifiable risk factors were analyzed for association with perioperative stroke, defined as ischemic stroke ≤7 days after surgery.
resultsWe analyzed 53 surgeries, consisting of 39 individual patients undergoing indirect surgical revascularization of 74 hemispheres. Perioperative ischemic stroke occurred following five surgeries (9.4%). There were no instances of hemorrhagic stroke. Larger pre-to-postoperative decreases in hemoglobin (OR 3.90, p=0.017), hematocrit (OR 1.69, p=0.012) and blood urea nitrogen (OR 1.83, p=0.010) were associated with increased risk of perioperative ischemic stroke. Weight-adjusted intraoperative blood loss was not associated with risk of perioperative ischemic stroke (OR 0.94, p=0.796). Among children with sickle cell disease, all of whom underwent exchange transfusion within one week prior to surgery, none experienced perioperative stroke.
conclusionsDecreases in hemoglobin, hematocrit, and blood urea nitrogen between the preoperative and postoperative periods are associated with increased risk of perioperative stroke. These novel findings suggest that dilutional anemia, possibly due to standardly administered hyperhydration, may increase the risk of perioperative stroke in some children with moyamoya. Further work optimizing both mean arterial pressure and oxygen-carrying capacity in these patients, including consideration of alternative blood transfusion thresholds, is necessary.
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