Moyamoya disease is a disorder characterized by bilateral progressive steno-occlusion of the terminal internal carotid arteries with associated development of a fragile network of basal collateral vessels. It most commonly presents in children, but is also frequently seen in adults, especially in the third or fourth decade of life. Adults afflicted with this disease have very different clinical characteristics as compared with children. For example, adults more commonly present with hemorrhage than cerebral ischemia, while children present with cerebral ischemia nearly 75% of the time and very rarely present with hemorrhage. This significantly impacts treatment considerations for the adult-onset moyamoya patient, as cerebral revascularization, though well accepted in the context of cerebral ischemia, is relatively controversial for the prevention of rehemorrhage. The purpose of this article is to review the pertinent general features of moyamoya disease, examine the clinical characteristics associated with the adult-onset form of this disease, and provide a detailed discussion regarding the indications, operative techniques, and outcomes of direct and indirect revascularization surgical procedures.
Surgical treatment of moyamoya disease in pediatric patients--comparison between the results of indirect and direct revascularization procedures
Long-term follow-up study after extracranial-intracranial bypass surgery for anterior circulation ischemia in childhood moyamoya disease
Changes in cerebral hemodynamics following encephalo-duro-arterio-synangiosis (EDAS) in young patients with moyamoya disease.
Failure of extracranial-intracranial arterial bypass to reduce the risk of ischemic stroke. Results of an international randomized trial
Lipohyalinosis and miliary microaneurysms causing cerebral hemorrhage in a patient with moyamoya. A clinicopathological study
Smooth muscle cell proliferation and localization of macrophages and T cells in the occlusive intracranial major arteries in moyamoya disease
Surgical therapy for adult moyamoya disease. Can surgical revascularization prevent the recurrence of intracerebral hemorrhage?
Combined direct and indirect reconstructive vascular surgery on the fronto-parieto-occipital region in moyamoya disease
Direct and indirect revascularization for moyamoya disease surgical techniques and peri-operative complications
Moyamoya disease in adults: characteristics of clinical presentation and outcome after encephalo-duro-arterio-synangiosis
Guidelines for the diagnosis and treatment of spontaneous occlusion of the circle of Willis ('moyamoya' disease). Research Committee on Spontaneous Occlusion of the Circle of Willis (Moyamoya Disease) of the Ministry of Health and Welfare, Japan
Effectiveness of superficial temporal artery-middle cerebral artery anastomosis in adult moyamoya disease: cerebral hemodynamics and clinical course in ischemic and hemorrhagic varieties
Clinical course, surgical management, and long-term outcome of moyamoya patients with rebleeding after an episode of intracerebral hemorrhage: An extensive follow-Up study
Linkage of familial moyamoya disease (spontaneous occlusion of the circle of Willis) to chromosome 17q25
Effect of direct arterial bypass on the prevention of future stroke in patients with the hemorrhagic variety of moyamoya disease
Combined encephaloduroarteriosynangiosis and bifrontal encephalogaleo(periosteal)synangiosis in pediatric moyamoya disease
Superficial temporal artery-to-middle cerebral artery bypass grafting for cerebral revascularization
Relative contributions of the middle meningeal artery and superficial temporal artery in revascularization surgery for moyamoya syndrome in children: the results of superselective angiography
Outcome of repeat revascularization surgery for moyamoya disease after an unsuccessful indirect revascularization. Clinical article
Effectiveness of burr holes for indirect revascularization in patients with moyamoya disease-a review of the literature
Surgical management of acute intracranial hemorrhage, surgical aneurysmal and arteriovenous malformation ablation, and other surgical principles
A novel heterozygous missense mutation 377T > C (V126A) of TGIF gene in a family segregated with holoprosencephaly and moyamoya disease
Effect of transfusion on cerebral oxygenation, flow velocity in a patient with sickle cell anemia and Moyamoya disease: a case report
'Smoke in the air': a rare cerebrovascular cause of neurological signs and symptoms in a young adult
Surgical Revascularization in North American Adults with Moyamoya Phenomenon: Long-Term Angiographic Follow-up
The importance of encephalo-myo-synangiosis in surgical revascularization strategies for moyamoya disease in children and adults
Intraventricular hemorrhage long after successful encephaloduroarterio synangiosis in moyamoya patient.
Is local hypoperfusion the reason for transient neurological deficits after STA-MCA bypass for moyamoya disease?
Direct versus indirect revascularization procedures for moyamoya disease: a comparative effectiveness study
Microsurgical Repair of Ruptured Aneurysms Associated with Moyamoya-Pattern Collateral Vessels of the Middle Cerebral Artery: A Report of Two Cases
Magnetic Resonance Imaging (MRI) and Digital Subtraction Angiography Investigation of Childhood Moyamoya Disease
Impact of extracranial-intracranial bypass on cerebrovascular reactivity and clinical outcome in patients with symptomatic moyamoya vasculopathy
Superficial temporal artery-to-middle cerebral artery bypass in combination with indirect revascularization in moyamoya patients ≤ 3 years of age
Multimodal neuronavigation-guided precision bypass in adult ischaemic patients with moyamoya disease: study protocol for a randomised controlled trial
Emergent Double-barrel Bypass Shortly after Intravenous Administration of Recombinant Tissue Plasminogen Activator for Acute Ischemic Stroke
Rupture of a Middle Meningeal Artery Pseudoaneurysm in Moyamoya Syndrome Related with Tuberculous Meningitis
Clinical and angiographic outcomes after combined direct and indirect bypass in adult patients with moyamoya disease: A retrospective study of 76 procedures
Moyamoya-like vasculopathy associated to MYH9-related thrombocytopenia manifested by multiple cerebral ischemic lesions: a case report
Patient Selection and Clinical Efficacy of Urgent Superficial Temporal Artery-Middle Cerebral Artery Bypass in Acute Ischemic Stroke Using Advanced Magnetic Resonance Imaging Techniques
Brain ischemia is a condition in which there is insufficient blood flow to the brain to meet metabolic demand. Discover the latest research on brain ischemia here.