Treatments for Moyamoya Disease
Medical Management
Medical management of moyamoya disease includes the following:
maintenance of hydration
use of antiplatelet agents like aspirin or Plavix (clopidogrel bisulfate)
moderate control of hypertension
It is important to use caution when treating moyamoya-induced hypertension, because low blood pressure can lead to a stroke if you have moyamoya disease. Despite medical management, the incidence of subsequent stroke in all patients with moyamoya disease ranges from 60 to 80%. Consequently, the gold-standard treatment for moyamoya disease is revascularization surgery, a procedure that increases blood flow to the affected region of the brain.
Surgical Revascularization
Revascularization procedures can include direct bypasses and indirect bypasses:
In a direct bypass, surgical connections (anastomoses) are made between branches of your external and internal carotid arteries.
In an indirect bypass, tissues such as arteries, muscle, galea (a tough, fibrous tissue underneath your scalp), or dura (the covering of your brain) are placed on the surface of your brain. The area of your brain suffering from insufficient blood flow (ischemia) naturally causes blood vessels to reconnect between the transplanted tissues and ischemic arteries on the surface of your brain. This process restores blood flow to the affected area.