ArticleNeuroImage. Clinical2021
Contralateral improvement of cerebrovascular reactivity and TIA frequency after unilateral revascularization surgery in moyamoya vasculopathy.
Article in NeuroImage. Clinical, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 12 papers, 1 of them a synthesis that pooled it.
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12 citing papers in PubMed, 1 synthesis or guideline pooled it, 19 citations in OpenAlex.
- Therapeutic Management of Ocular Ischemia in Takayasu's Arteritis: A Case-Based Systematic Review.Frontiers in immunology · 2021Pooled it
- Pial collateral shift after unilateral bypass in bilateral moyamoya disease: illustrative cases.Journal of neurosurgery. Case lessons · 2025Article
- Post-anesthesia care unit delirium in children with moyamoya disease undergoing indirect revascularization: incidence and risk factors.Korean journal of anesthesiology · 2025Article
- Impact of Revascularization Timing on Clinical Outcomes of Symptomatic Moyamoya Disease: A Systematic Review and Multivariate Analysis.Neurosurgery practice · 2025Review
- Cerebrovascular reactivity: a stress test of brain vascular health in moyamoya disease.Brain communications · 2025Article
- Increased Parenchymal Free Water May Be Decreased by Revascularization Surgery in Patients with Moyamoya Disease.Magnetic resonance in medical sciences : MRMS : an official journal of Japan Society of Magnetic Resonance in Medicine · 2024Article
- Natural course of hemodynamically stable hemispheres contralateral to operated hemispheres in adult patients with ischemic moyamoya diseases.Scientific reports · 2024Article
- Outcome prediction of pediatric moyamoya disease using midterm cerebral blood flow measured between staged anastomoses.Child's nervous system : ChNS : official journal of the International Society for Pediatric Neurosurgery · 2023Article
- Anesthesia Depresses Cerebrovascular Reactivity to Acetazolamide in Pediatric Moyamoya Vasculopathy.Journal of clinical medicine · 2023Article
- Clinical Outcome, Cognition, and Cerebrovascular Reactivity after Surgical Treatment for Moyamoya Vasculopathy: A Dutch Prospective, Single-Center Cohort Study.Journal of clinical medicine · 2022Article
- Postoperative cerebral infarction after revascularization in patients with moyamoya disease: Incidence and risk factors.Frontiers in neurology · 2022Article
- Vascular smooth muscle cell dysfunction in neurodegeneration.Frontiers in neuroscience · 2022Review
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Authors and funding
9 authors at 3 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
objectiveMoyamoya vasculopathy is a rare, often bilateral disease characterized by progressive stenosis and occlusion of the distal internal carotid artery, leading to a progressive deterioration of cerebrovascular reactivity (CVR) and increased risk of transient ischemic attacks (TIAs), infarction and hemorrhage. Surgical revascularization is a widely accepted symptomatic treatment, often performed bilaterally in one or two stages. To possibly further optimize treatment strategy, we investigated the effect of unilateral revascularization surgery on the CVR of, and TIA frequency originating from, the contralateral hemisphere.
methodsFrom our database of 143 moyamoya vasculopathy patients we selected those with bilateral disease, who underwent hemodynamic imaging ([15O]H2O positron emission tomography (PET)-CT with acetazolamide challenge) before and 14 months (median) after unilateral revascularization. We evaluated CVR in three regions per hemisphere, and averaged these per hemisphere for statistical comparison. Conservatively treated patients were showed as a comparison group. To examine TIA frequency, we selected patients who presented with TIAs that (also) originated from the contralateral - not to be operated - hemisphere. We scored changes in CVR and TIA frequency of the ipsilateral and contralateral hemisphere over time.
resultsSeven surgical and seven conservative patients were included for CVR comparison. Of the 20 scored contralateral regions in the surgical group, 15 showed improved CVR after unilateral revascularization, while 5 remained stable. The averaged scores improved significantly for both hemispheres. In conservatively treated patients, however, only 3 of the 20 scored regions improved in the least-affected (contralateral) hemispheres, and 9 deteriorated. From the 6 patients with contralateral TIAs at presentation, 4 had a decreased TIA frequency originating from the contralateral hemisphere after unilateral surgery, while 2 patients remained stable.
conclusionBoth CVR and TIA frequency in the contralateral hemisphere can improve after unilateral revascularization surgery in bilateral MMV.
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