In our previous blog, we discussed the diagnosis of Moyamoya disease using medical imaging such as CT and MRI. Patients with Moyamoya disease often have a higher risk for stroke due to their abnormal blood vessels in the brain. Once the diagnosis is confirmed, several treatment strategies are available to prevent strokes from happening. One of the most effective ways is bypass surgery.
In essence, a bypass surgery connects a blood vessel from outside the brain to a vessel inside the brain to redirect blood flow around a blocked artery. The figure in this blog illustrates the bypass procedure for Moyamoya patients. In this case, the superficial temporal artery (STA) outside the brain is connect to the middle cerebral artery (MCA) inside the brain to restore cerebral blood flow (CBF). It is a very complicated procedure that often requires more than 6 hours to perform by well-trained neurosurgeons. If the patient has blocked vessels on both sides of the brain, the neurosurgeon often has to perform two procedures to treat each side separately. After the surgery, the patient will recover in the ICU before being discharged. The patient will also need to have regular imaging exams such as MRI or CT after the surgery. The images can help doctors monitor the recovery from the surgery and identify any new vessel occlusions and risk for strokes.
At Stanford Moyamoya center, Dr. Gary Steinberg is an eminent neurosurgeon who has performed hundreds of such bypass surgeries for Moyamoya patients all over the world. The center offers a highly experienced group of professionals who see several new patients every week, making Stanford the largest Moyamoya referral center in the world. The bypass procedures require approximately three days of hospitalization at Stanford Hospital or Lucile Packard Children’s Hospital Stanford. Post-operatively, patients experience some minor scalp pain from the incision while some patients may get mild headaches. Patients with Moyamoya have minimal restrictions after surgery. The Moyamoya center also has a team to support international patients who want to receive care and treatment in the US.
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Dr. Moss Zhao is an AHA Postdoctoral Fellow at Stanford University. His research interests include developing advanced and clinically viable imaging technologies for cerebrovascular diseases and characterizing the metabolic demands in the first two decades of human brain development. He is passionate about science communication and public engagement.