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Surgical Treatment of Adult Moyamoya Disease

  • Cerebrovascular Disorders (DG Jamieson, Section Editor)
  • Published:
Current Treatment Options in Neurology Aims and scope Submit manuscript

Abstract

Purpose of review

Moyamoya disease (MMD) is being increasingly diagnosed with the development of radiological surveillance technology and increased accessibility to medical care. Accordingly, there have been several recent reports on treatment outcomes in MMD. In this review, we summarize recent advances in surgical treatment and outcomes of adult MMD, while addressing related controversies.

Recent findings

Recent studies suggest that revascularization surgery leads to significantly more favorable outcomes for stroke prevention, angiographic and hemodynamic changes, and clinical outcomes than does conservative treatment for adult patients with ischemic MMD. Moreover, direct revascularization methods should be considered as the first-line treatment over indirect methods, although the latter may be considered if a direct method is not possible. In cases of hemorrhagic MMD, several studies have demonstrated that surgical treatment is more effective than conservative treatment in preventing further hemorrhage. In addition to revascularization surgery, endovascular treatment is emerging as a breakthrough therapy for hemorrhagic MMD.

Summary

Accumulating evidence regarding the surgical treatment of adult MMD suggests the benefit of revascularization over conservative management for both ischemic and hemorrhagic patients. However, the benefit of revascularization in asymptomatic adult MMD remains unclear.

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References and Recommended Reading

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Authors and Affiliations

  1. Department of Neurosurgery, Seoul National University Bundang Hospital, 82, Gumi-ro 173 Beon-gil, Bundang-gu, Seongnam-si, Gyeonggi-do, 13620, Republic of Korea

    Si Un Lee MD, Chang Wan Oh MD, PhD, O-Ki Kwon MD, PhD, Jae Seung Bang MD, Seung Pil Ban MD, Hyoung Soo Byoun MD & Tackeun Kim MD

  2. Department of Neurosurgery, Seoul National University College of Medicine, 101 Daehak-Ro Jongno-Gu, Seoul, 03080, Republic of Korea

    Si Un Lee MD, Chang Wan Oh MD, PhD, O-Ki Kwon MD, PhD, Jae Seung Bang MD, Seung Pil Ban MD, Hyoung Soo Byoun MD & Tackeun Kim MD

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  1. Si Un Lee MD
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  2. Chang Wan Oh MD, PhD
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  3. O-Ki Kwon MD, PhD
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  4. Jae Seung Bang MD
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Correspondence to Tackeun Kim MD.

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Lee, S.U., Oh, C.W., Kwon, OK. et al. Surgical Treatment of Adult Moyamoya Disease. Curr Treat Options Neurol 20, 22 (2018). https://doi.org/10.1007/s11940-018-0511-8

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