Surgical treatment of moyamoya disease
Moyamoya disease is a rare vascular condition characterised by the progressive narrowing of arteries supplying oxygen and essential nutrients to the brain. This occlusion encourages the formation of a network of small blood vessels to bypass the blockage. Most commonly occurring among children and adolescents of Asian race, moyamoya can lead to damage or death of brain tissue, producing headaches, cognitive or learning difficulties, seizures and mental retardation. Medical emergencies may include intracranial haemorrhage (bleeding in the brain), transient ischemic attack (numbness, weakness, speech impairment or visual abnormalities) or a complete stroke, which require immediate medical interventions.
Surgery is usually the main form of treatment to prevent stroke and permanent neurological deficits. It involves redirecting blood towards the oxygen-deficient areas of the brain from other parts of the head such as arteries in the scalp or muscles. Surgery can be performed through direct revascularisation, by connecting superficial arteries on the scalp to those inside the skull, or less commonly via indirect revascularisation by laying arteries or muscles on the surface of the brain. As the brain receives more blood from indirect revascularisation, it forms new vessels over time (6 to 8 weeks), further enhancing blood supply. Following direct revascularisation, you may require 3 to 5 days of hospital stay, and 2 to 6 weeks to resume your regular activities. As with all surgical procedures, revascularisation may have some risk of bleeding or stroke, but are found to have good overall long-lasting results.
