Moyamoya disease (MMD) is a progressive cerebrovascular disease with unknown etiology, characterized by steno‒occlusive changes at the terminal portion of the internal carotid artery and an abnormal vascular network formation at the base of the brain. The diagnostic criteria for MMD were updated in 2015 and included not only typical MMD patients with bilateral involvement but also patients with unilateral involvement and/or with atherosclerosis into definitive MMD. Surgical interventions including revascularization surgery comprising direct bypass has been known to prevent cerebral ischemic attack by improving cerebral blood flow and, as more recently shown, could reduce the potential risk of re‒bleeding in MMD patients with posterior hemorrhage, who have regular and extremely high re‒bleeding rate. Based on modern diagnostic criteria and increasing evidence for revascularization surgery, more MMD patients have lately undergone bypass surgery. We therefore aimed to review modern diagnostic criteria and indication of surgical revascularization for MMD.
- Extracranial‒intracranial bypass
- Moyamoya disease
- Revascularization surgery
- Surgical indication