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 signif- icantly more favorable outcomes for stroke prevention, angiographic and hemody- namic 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 revascular- ization 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 22 Page 2 of 14 Curr Treat Options Neurol (2018) 20:22 ischemic and hemorrhagic patients. However, the benefit of revascularization in asymptomatic adult
Current Treatment Options in Neurology – Springer Journals
Published: May 28, 2018
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