Moyamoya Arteriopathy

@article{Smith2012MoyamoyaA,
  title={Moyamoya Arteriopathy},
  author={Edward R. Smith},
  journal={Current Treatment Options in Neurology},
  year={2012},
  volume={14},
  pages={549-556}
}
  • Edward R. Smith
  • Published 2012
  • Medicine
  • Current Treatment Options in Neurology
Opinion statementThe arteriopathy of moyamoya is progressive and results in severe disability from cerebral ischemia. Once the diagnosis is confirmed with magnetic resonance imaging (MRI) and catheter angiography, initial measures should consist of administration of low dose aspirin (usually 81 mg daily, barring pre-existing contraindications), maintenance of good hydration and avoidance of hyperventilation (to reduce the risk of reflex cerebral vasoconstriction). Definitive treatment is… 
Recent Advances in Moyamoya Disease: Pathophysiology and Treatment
TLDR
There are strong indications that neurosurgical intervention, through direct, indirect, or combined revascularization surgery, can reduce the risk of ischemic stroke and possibly also cognitive dysfunction by improving cerebral perfusion, although randomized clinical trials have not been performed.
Enfermedad de Moyamoya: reporte de un caso. Moyamoya disease: A case report.
TLDR
The case of a Peruvian male of Japanese ancestry without risk factors, with an intracranial hemorrhage who was finally diagnosed with Moyamoya disease is reported.
Analysis of Factors Related to Cerebral Infarction after Direct Bypass Surgery in Adults with Moyamoya Disease
TLDR
High-risk factors of the patients with moyamoya disease were analyzed to provide the basis for prediction and management of cerebral infarction after direct bypass surgery in adult MMD and showed that the possibility of a new cerebralInfarction in postoperative patients with a history of cerebralinfarction was greater.
Time Course of Neoangiogenesis After Indirect Bypass Surgery for Moyamoya Disease
TLDR
After indirect bypass surgery, the major time window of arterial neoangiogenesis development was within 6 months after surgery, and the general effect of revascularization was very similar in the short and long term; therefore, a follow-up angiography scheduled at 6  Months after surgery is recommended.
Moyamoya Disease in a 70 Year Old Nigerian Male: A Case Report
TLDR
The index patient was frail, unfit and therefore could not benefit from surgical revascularization procedure which is the main treatment option for moyamoya disease, which is a rare cause of ischaemic stroke in an elderly male.
Direct Bypass Surgery Vs. Combined Bypass Surgery for Hemorrhagic Moyamoya Disease: A Comparison of Angiographic Outcomes
TLDR
The potential of indirect bypass to grow new vessels in hemorrhagic-MMD patients was generally limited, but dural leaflets offered better neoangiogenesis than STA grafts and was therefore recommended for surgical revascularization of hemorrhagic MMD.
The collateral circulation in pediatric moyamoya disease
TLDR
The previously inexplicitly described “moyamoy abnormal network” in pediatric moyamoya disease can be described as a composition of four anastomotic networks with distinct angioarchitecture.
Selective and Superselective Angiography of Pediatric Moyamoya Disease Angioarchitecture: The Anterior Circulation
TLDR
High quality selective and superselective angiography enabled us to clearly demonstrate for the first time aspects of the microangiographic anatomy of the moyamoya anastomotic network previously only vaguely or incompletely described.
Comparison of Long-Term Effect Between Direct and Indirect Bypass for Pediatric Ischemic-Type Moyamoya Disease: A Propensity Score-Matched Study
TLDR
Both techniques were effective in improving the neurological status of pediatric isChemic-type MMD patients, and direct bypass surgery might be more superior in preventing recurrent ischemic strokes in the short-term.
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References

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TLDR
The refinement of catheter angiography techniques and the development of the imaging modalities of CT and MR imaging clarified the significance of making the correct diagnosis of moyamoya disease in affected patients.
Pial synangiosis in patients with moyamoya syndrome and sickle cell anemia: perioperative management and surgical outcome.
TLDR
Operative treatment of moyamoya syndrome using pial synangiosis appears to be safe and confers long-lasting protection against further stroke in this population, and provides an alternative for failure of optimal medical therapy in patients.
Anesthetic management of children with moyamoya syndrome.
TLDR
The experience in children who underwent the same intraoperative regimen for the treatment of moyamoya syndrome was reviewed, and anesthetic management during surgical procedures on these patients must minimize the risk of perioperative strokes.
Angioplasty for Acute Stroke With Pediatric Moyamoya Syndrome
TLDR
The paucity of data regarding angioplasty and other forms of endovascular intervention in pediatric cerebrovascular disease and moyamoya vasculopathy is discussed.
Long-term outcome in children with moyamoya syndrome after cranial revascularization by pial synangiosis.
TLDR
Following pial synangiosis, the majority of pediatric patients with moyamoya syndrome stop having strokes and TIAs, and they appear to experience an excellent long-term prognosis.
Discovery of asymptomatic moyamoya arteriopathy in pediatric syndromic populations: radiographic and clinical progression.
TLDR
It is demonstrated that moyamoya is a progressive disorder, even in asymptomatic populations, and support the rationale of early surgical intervention to minimize morbidity from stroke.
Spontaneous occlusion of the circle of Willis in children: pediatric moyamoya summary with proposed evidence-based practice guidelines. A review.
TLDR
Current studies of pediatric moyamoya are summarized to provide a framework for construction of evidence-based guidelines for treatment, and the compilation of current data in these guidelines should serve as a resource to aid pediatric neurosurgeons in their role as advocates for providing appropriate care to affected children.
Failure of Primary Percutaneous Angioplasty and Stenting in the Prevention of Ischemia in Moyamoya Angiopathy
TLDR
Angioplasty and stenting may temporarily improve the cerebral blood flow and decrease cerebral ischemic events but do not appear to be durable nor provide long-term prevention against future ischeMIC events.
Moyamoya: to cut or not to cut is not the only question. A paediatric neurologist’s perspective
  • V. Ganesan
  • Medicine
    Developmental medicine and child neurology
  • 2010
TLDR
The most frequent management issues for the paediatric neurologist, other than when to refer for surgery, are headache, hypertension, and the concern of the family that other children might be affected.
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