Post-anesthesia care unit delirium in children with moyamoya disease undergoing indirect revascularization: incidence and risk factors.

Background: Delirium in the post-anesthesia care unit (PACU) may be associated with worse outcomes in children with moyamoya disease (MMD). This retrospective study aimed to describe the prevalence of PACU delirium in children with MMD and investigate its risk factors.

Methods: Patients with MMD aged < 15 years who underwent indirect revascularization between January 2014 and October 2023 were included in this study.

Rete anomaly of the middle cerebral artery: case series of 13 patients from the Northeastern United States.

Background: Rete middle cerebral artery (MCA) is a rare anomaly of the intracranial circulation that mimics congenital Moyamoya disease (MMD). Similar to MMD, it is reported almost exclusively in East-Asian ethnicities. Here, we report 13 patients with rete MCA anomaly from a predominantly non-Asian background in the USA.

Usefulness of Three-dimensional Computer Graphics for the Direct Surgery of Ruptured Aneurysms in Deep Collateral Arteries Arising after Indirect Revascularization for Moyamoya Disease: Report of Two Cases.

Treating ruptured aneurysms in deep collateral arteries in moyamoya disease is difficult. Two cases of intracranial hemorrhage due to ruptured aneurysms in the deep collateral vessels after indirect revascularization for moyamoya disease were treated via direct surgery with the assistance of surgical simulation using three-dimensional computer graphics. The three-dimensional computer graphics provided detailed anatomical relationships between the aneurysm and the surrounding structures, which led to successful surgical results in both patients.

Role of Vessel Wall Magnetic Resonance Imaging in the Diagnosis of Intracranial Vasculopathies.

Background: Stroke is a leading cause of death and disability worldwide, affecting millions annually. Accurate etiological diagnosis is critical for the effective treatment and prevention of recurrent strokes. Traditional luminal imaging techniques like computed tomography (CT) and magnetic resonance angiography (MRA) provide limited information, focusing solely on vessel lumen characteristics.

Emergency neurosurgical hybrid operating platform for acute intracranial hemorrhage (E-HOPE).

Background: Precise diagnosis and rapid treatment for acute complex intracranial hemorrhage (ICH) are crucial. The neurosurgical hybrid operating platform integrates traditional open neurosurgery operating room functionalities with endovascular therapy capabilities and is developing in the neurosurgical practice. However, its effect on the emergent complicated neurovascular cases needs pilot exploration.

Clinical features and endovascular treatment of ruptured peripheral cerebral aneurysms associated with moyamoya disease: an 8-year single-center experience.

Objective: Ruptured peripheral cerebral aneurysm (PPCA) associated with moyamoya disease (MMD) is rarely reported, and its optimal treatment remains controversial. This study aims to present the clinical characteristics, treatment strategies, and outcome predictors of this rare clinical entity.

Methods: A retrospective review of patients with hemorrhagic MMD from January 2013 to December 2020 was performed.

Direct STA-MCA Bypass in Moyamoya Disease: Predicting Post-Operative Symptomatic Contralateral Stroke Using Clinical Characteristics and Angiographic Collateralization Patterns.

Background: Moyamoya disease (MMD) is a rare cerebrovascular disorder marked by internal carotid artery narrowing, collateral neovascularization, and symptomatic cerebral ischemia. Select patients can benefit from direct bypass (STA-MCA bypass) by restoring blood flow to hypoperfused territories. Symptomatic contralateral stroke (CS) following STA-MCA bypass is a devastating, poorly understood complication.

Innate Immune Cell Profiling in Peripheral Blood Mononuclear Cells of Patients with Moyamoya Disease.

Moyamoya disease (MMD) is a rare cerebrovascular disease characterized by stenosis or occlusion of the internal carotid artery, thus leading to ischaemic and haemorrhagic strokes. Although genetic studies have identified ring finger protein 213 (RNF213) as a susceptibility gene, the low disease penetrance suggests that a secondary trigger, such as infection, may initiate disease onset. This study aimed to characterize the innate immune cell profile of peripheral blood mononuclear cells (PBMCs) of MMD patients via mass cytometry (CyTOF).

miR-6760-5p suppresses neoangiogenesis by targeting Yes-associated protein 1 in patients with moyamoya disease undergoing indirect revascularization.

Objective: The aim of this research was to investigate the specific regulatory role of miR-6760-5p in angiogenesis in moyamoya disease.

Methods: HUVECs were transfected with miR-6760-5p inhibitor and mimics fragments, then subjected to assays for cell proliferation, migration, and tube formation. Subsequently, downstream target genes of miR-6760-5p were predicted and the protein expression levels of these genes were evaluated.

Comparing Outcomes of Moyamoya Disease and Moyamoya Syndrome in a Real-World Scenario: A Cohort Study.

Background: Moyamoya disease (MMD) and moyamoya syndrome (MMS) are rare cerebrovascular conditions with unclear distinctions in clinical presentation and prognosis.

Aim: This study assessed potential differences between MMD and MMS patients using real-world data on clinical manifestations, surgical outcomes, and stroke risk factors.

Methods: This multicenter, retrospective cohort study examined patients with MMD or MMS treated at three tertiary academic hospitals in China, with a mean follow-up of 11.

Moyamoya Angiopathy and Antiphospholipid Antibodies: A Coincidental Association?

Background: The presence of antiphospholipid antibodies (aPL) has been suggested as a potential cause of moyamoya angiopathy (MMA), but this remains uncertain. In this case-control study, we aimed to compare the prevalence of circulating aPL in patients with MMA and in non-MMA cerebrovascular controls.

Methods: For comparison, we included 95 patients with MMA from the French National Referral Centre for this condition and 182 age- and sex-matched non-MMA controls with a different cerebrovascular disease, all younger than 55 years.

Benefits and risks of antiplatelet therapy after bypass surgery for moyamoya disease: A meta-analysis.

Background: Bypass surgery is a leading treatment strategy for moyamoya disease. Antiplatelet therapy (APT) has the potential to prevent thrombosis and possibly enhance bypass graft patency. However, the efficacy and safety of APT following bypass surgery remain debatable.

The impact of cerebrovascular steno-occlusive disease subtype on surgical and clinical outcomes after direct STA-MCA bypass surgery.

Objective: Although well-established in moyamoya disease (MMD), the role of direct superficial temporal artery (STA) to middle cerebral artery (MCA) bypass in non-MMD (N-MMD) cerebrovascular steno-occlusive syndromes remains controversial. Nonetheless, the recurrent stroke risk in patients with N-MMD, despite best medical management, remains exceedingly high-especially for those suffering from hypoperfusion-related ischemia. The study objective was to determine the relative safety and efficacy profiles of direct STA-MCA bypass surgery for MMD and N-MMD patients in a large contemporary cohort.

Identification of the optimal thresholds for the hypoperfusion intensity ratio in moyamoya disease.

Objective: The authors' objective was to retrospectively compare two methods for defining the hypoperfusion intensity ratio (HIR) in moyamoya disease (MMD) by using hypoperfused volumes calculated from time to maximum of the residue function (Tmax) thresholds of 10 seconds/4 seconds and 10 seconds/6 seconds.

Methods: All hemispheres were categorized into normal, ischemic, and hemorrhagic groups. Hypoperfused volumes were calculated using Tmax thresholds of 10 seconds, 6 seconds, and 4 seconds.

TdCCA with Dual-Modal Signal Fusion: Degenerated Occipital and Frontal Connectivity of Adult Moyamoya Disease for Early Identification.

Cognitive impairment in patients with moyamoya disease (MMD) manifests earlier than clinical symptoms. Early identification of brain connectivity changes is essential for uncovering the pathogenesis of cognitive impairment in MMD. We proposed a temporally driven canonical correlation analysis (TdCCA) method to achieve dual-modal synchronous information fusion from electroencephalogram (EEG) and functional near-infrared spectroscopy (fNIRS) for exploring the differences in brain connectivity between MMD and normal control groups.

The significance of postbypass blood flow model in side to side bypass for moyamoya disease in predicting postoperative cerebral hyperperfusion syndrome.

Objective: We previously developed the use of side to side (s-s) bypass for the treatment of adult moyamoya disease (MMD) and discovered several kinds of distinct blood flow models intraoperatively, which we observed through indocyanine green-video angiography (ICG-VA). The purpose of this paper was to investigate the correlation between blood flow model (BFM) identified in s-s bypass and the incidence of postoperative cerebral hyperperfusion syndrome (CHS) among patients with MMD.

Methods: We analyzed 166 hemispheres from 153 patients diagnosed with MMD, including 118 hemispheres with s-s bypass and 48 with end to side (e-s) bypass.

DTI and fMRI alterations in a surgically-treated patient with moyamoya disease suffering severe speech impairments.

Moyamoya is a rare chronic brain vascular disease with a set of potential life-threatening consequences due to a high probability of stroke occurrence. Here we present a case of a patient with moyamoya disease, who has been dynamically observed over more than 4 years after the first manifestation of her symptoms. In this study we report fMRI and DTI findings obtained at the final follow-up point, four years after two revascularization surgeries were successfully performed.

Moyamoya Disease and Carotid Web in a Young Adult With Ischemic Stroke: A Case Report.

A rare case of ischemic stroke in a young adult demonstrating coexistence of moyamoya disease and carotid web in angiography was reported. Early recognition and prompt intervention should be stressed in individuals with cryptogenic stroke.

Angiographic features and progression risk factors in children with asymptomatic moyamoya disease.

Objective: This study aims to explore the potential contribution of angiographic characteristics in the increased stroke risk among pediatric patients.

Methods: This study retrospectively enrolled pediatric patients with ischemic, hemorrhagic, and asymptomatic moyamoya disease. Their hemispheres were categorized into five groups for the analysis of angiographic characteristics, which included Suzuki's stage, moyamoya vessels, lenticulostriate artery, thalamotuberal artery, thalamoperforating artery, anterior choroidal arteries, posterior choroidal arteries, and posterior cerebral artery involvement.

Homozygous variant in translocase of outer mitochondrial membrane 7 leads to metabolic reprogramming and microcephalic osteodysplastic dwarfism with moyamoya disease.

Background: Impaired mitochondrial protein import machinery leads to phenotypically heterogeneous diseases. Here, we report a recurrent homozygous missense variant in the gene that encodes the translocase of outer mitochondrial membrane 7 (TOMM7) in nine patients with microcephaly, short stature, facial dysmorphia, atrophic macular scarring, and moyamoya disease from seven unrelated families.

Methods: To prove the causality of the TOMM7 variant, mitochondrial morphology, proteomics, and respiration were investigated in CRISPR/Cas9-edited iPSCs-derived endothelial cells.