Signs and Symptoms

Moyamoya typically affects children, adolescents and young adults, although it is also seen in older adults. Children with moyamoya may experience the following symptoms:

• Stroke

• Recurrent transient ischemic attacks (TIAs), in which the blood supply to the brain becomes blocked. This prevents oxygen and nutrients from reaching brain cells.

• Muscular weakness or paralysis that affects one side of the body, also known as hemiparesis

• Seizures

• Speech problems

• Sensory and cognitive impairments

• Involuntary movements

• Vision problems

Diagnosis

Your doctor will begin by conducting a thorough physical examination of your child. If he or she suspects moyoma, they will recommend a test called a cerebral angiography. During this procedure, an X-ray is taken to examine the brain's arteries, but first dye is injected into the arteries to make them easier to see on the X-ray.

Treatment

Unfortunately there is no cure for moyamoya. However, children who suffer from strokes and recurrent transient ischemic attacks may be given aspirin and other medications to reduce the risk of future attacks.

In addition, there are several types of surgery that have been designed to treat moyamoya. These operations aim to help the blood and oxygen starved brains of children with moyamoya to develop new and more efficient means of bringing blood to the brain by bypassing the areas of blockage.

At UCSF Children's Hospial, our neurosurgeons perform two general types of surgery for moyamoya:

• Indirect Bypass or Encephaloduroarteriosynangiosis (EDAS) Bypass -- With this procedure, the neurosurgeon takes an artery that normally goes to the scalp and, after making a small hole in the skull, lays the artery on the surface of the brain. Over time, this artery sprouts branches, called collaterals, which actually feed blood to the brain.

• Direct Bypass or External Carotid to Internal Carotid Artery Bypass (EC-IC) Bypass -- With this procedure, the neurosurgeon again uses a blood vessel to the scalp, but instead of just laying it on top of the brain, he or she directly connects it to one of the existing blood vessels in the brain. Although this procedure is more invasive than the indirect bypass, it provides an immediate effect.