Posted by jv on March 24, 2003 at 02:11:10:
In Reply to: Pediatric prognosis posted by DJ on March 22, 2003 at 12:11:53:
I would think that since effective non-direct by-pass techniques have been rather recently developed, long term experience is only starting to accumulate. It is also known that MM can proceed in vastly different paces, and in some cases manifest itself only at mature age, even over 50-60. In adult cases, docs can not fully guarantee if the changes in the arteries have actually been there for decades! But adult cases seem to be quite different to pediatric...
This is from japanese MM pages at http://www003.upp.so-net.ne.jp/moya-moya/
"Kurokawa et al reported on the prognosis of 27 patients aged between 11 months and 4 years and 11 months. Observation periods ranged within 4 years (13 patients), 5-9 years (5 patients), and 10-15 years (9 patients). Eleven patients underwent surgical treatment and their prognosis before surgery was included. Transient ischemic attacks were frequently observed in the first 4 years, but decreased thereafter. Intellectual deterioration and motor impairment increased with time. There was no sexual differences. Outcome included normal in five (19%), occasional transient ischemic attacks or headache alone in nine (33%), mild intellectual and/or motor impairment in seven (26%), requirement for special school or care by parents or institutions after reaching the teen years in three (11%), continuous 24-hour care in two (7%), and death in one (3%). Poor prognosis was correlated with an early age at onset and hypertension. "