Moyamoya disease in adults: treatment methods in modern era

Krylov V.V.; Senko I.V.; Amiralieva M.Sh.; Staroverov M.S.; Grigoryev I.V.; Kordonskaya O.O.; Glotova N.A.

doi:https://doi.org/10.17116/jnevro202412403275

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Aneurysms associated with moyamoya angiopathy (clinical cases). Burdenko's Journal of Neurosurgery. 2025;(6):96-104

Abstract:

Moyamoya angiopathy is a chronic progressive cerebrovascular disease characterized by stenosis and occlusion of the distal segments of the internal carotid arteries and/or proximal segments of the middle and anterior cerebral arteries, with a gradual compensatory restructuring of the cerebral circulation to the system of the external carotid arteries. Today, the main treatment method for Moyamoya angiopathy is surgical revascularization of the brain. A search and analysis of publications on the treatment of adult patients with Moyamoya angiopathy was carried out in the PubMed and Medscape databases over the past 10 years. We present a case of an adult female patient with a hemorrhagic form of Moyamoya angiopathy stage IV according to J. Suzuki, who underwent staged combined revascularization of both cerebral hemispheres. Surgical revascularization included the creation of a low-flow extra-intracranial shunt combined with a combination of indirect synangiosis. The combination of direct and indirect methods of surgical revascularization enables to achieve the development of an extensive network of collaterals and fully compensate for cerebral circulatory disorders both in the early and late postoperative periods, which is confirmed by instrumental diagnostic data. Combined revascularization is the most effective modern method of treating patients with Moyamoya angiopathy due to the complementary influence of direct and indirect components of revascularization.

Keywords:

moyamoya angiopathy

bypass revascularization

combined revascularization

Authors:

Krylov V.V.

Federal Center of Brain Research and Neurotechnology;
Pirogov Russian National Research Medical University;
Sklifosovsky Research Institute for Emergency Medicine

ORCID: 0000-0001-5256-0905

Senko I.V.

Federal Center of Brain Research and Neurotechnologies

ORCID: 0000-0002-5743-8279

Amiralieva M.Sh.

Federal Center of Brain Research and Neurotechnology

ORCID: 0000-0002-9140-0645

Staroverov M.S.

Federal Center of Brain Research and Neurotechnology;
Sklifosovsky Research Institute for Emergency Medicine;
Clinical City Hospital No. 4

ORCID: 0000-0002-7341-797X

Grigoryev I.V.

Federal Center of Brain Research and Neurotechnology

ORCID: 0000-0002-1320-5772

Kordonskaya O.O.

Federal Center of Brain Research and Neurotechnology;
Pirogov Russian National Research Medical University

ORCID: 0000-0003-0432-2915

Glotova N.A.

Federal Center of Brain Research and Neurotechnology

ORCID: 0009-0003-4472-6604

Received:

14.10.2023

Accepted:

11.11.2023

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References:

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