Moyamoya Disease

Moyamoya disease is a rare condition in which the arteries supplying oxygen and essential nutrients to the brain gradually become narrowed. As a result, a network of small blood vessels develops to bypass the blockage and maintain blood flow. The condition can progress over time and may lead to serious complications, including brain haemorrhage, transient ischaemic attacks (TIAs), and paediatric stroke.

Symptoms

Moyamoya disease can cause stroke-like symptoms, including:

• Weakness on one side of the body
• Blurred vision
• Slurred speech
• Headaches
• Seizures

Reduced blood flow and damage to brain tissue may also result in:

• Cognitive or learning difficulties
• Behavioural changes
• Seizures
• Developmental delays
• Neurological impairment

Diagnosis and Treatment Options

To diagnose Moyamoya disease, a detailed medical history is obtained and a physical and neurological examination is performed to identify signs and symptoms. Diagnostic imaging studies, such as X-rays, computed tomography (CT) scans, and magnetic resonance imaging (MRI) scans, may be used to assess the condition.

A cerebral angiogram may be required to confirm the diagnosis. This procedure uses a contrast dye and X-ray imaging to provide detailed images of the blood vessels in the brain. A catheter is inserted into an artery in the groin and carefully guided to the blood vessels supplying the brain. Additional imaging studies may also be performed to identify areas of the brain with reduced blood flow and oxygen supply.

Surgery is often recommended to reduce the risk of stroke and permanent brain injury. The procedure involves redirecting blood flow to oxygen-deprived areas of the brain using blood vessels from other parts of the scalp or surrounding tissues.

Medications may also be prescribed to help manage symptoms and reduce the risk of complications. These may include antiplatelet medications, such as aspirin, and calcium channel blockers, which help improve blood flow, lower blood pressure, and reduce headaches.

Recovery

Recovery varies depending on the severity of the condition and the treatment received. Recovery may include:

• Temporary confusion and possible neurological deficits
• Rehabilitation
• Follow-up MRI scans
• Possible additional surgery
• Physiotherapy
• Occupational therapy
• Psychological support, if required
• Pain medication as needed
• Speech therapy