Evidence map›Paper›PMID 42754768›Full record

SynthesisNeurosurgical review2026

Predicting cerebral hyperperfusion syndrome after STA-MCA bypass in Moyamoya disease with CT perfusion through meta-regression.

David Cho, Cory Greer, Gerardo Duran, Michael J Feldman, Andrew M Bauer, Christopher S Graffeo

Abstract readSystematic ReviewMeta-Analysis
PubMed Publisher
In one paragraph

Synthesis in Neurosurgical review, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

0numbers the graph read from it
0cells of the map it votes in
0citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

0 citing papers in PubMed.

No citing paper in PubMed yet.

4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

6 authors.

David ChoDepartment of Neurosurgery, University of Oklahoma, 1000 N Lincoln Blvd, #4000, Oklahoma City, OKC, 73104, USA.
Cory GreerDepartment of Neurosurgery, University of Oklahoma, 1000 N Lincoln Blvd, #4000, Oklahoma City, OKC, 73104, USA.
Gerardo DuranDepartment of Neurosurgery, University of Oklahoma, 1000 N Lincoln Blvd, #4000, Oklahoma City, OKC, 73104, USA.
Michael J FeldmanDepartment of Neurosurgery, University of Oklahoma, 1000 N Lincoln Blvd, #4000, Oklahoma City, OKC, 73104, USA.
Andrew M BauerDepartment of Neurosurgery, University of Oklahoma, 1000 N Lincoln Blvd, #4000, Oklahoma City, OKC, 73104, USA.
Christopher S GraffeoDepartment of Neurosurgery, University of Oklahoma, 1000 N Lincoln Blvd, #4000, Oklahoma City, OKC, 73104, USA. Graffeo@Gmail.com.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

While STA-MCA bypass is a standard intervention for Moyamoya disease (MMD), it may occasionally lead to cerebral hyperperfusion syndrome (CHS), a rare but serious postoperative complication. While perfusion imaging is emerging as a potential tool to predict the risk of developing CHS, its utility remains underexplored. This meta-regression assesses the prognostic value of preoperative, postoperative, and differential CTP parameters in predicting CHS among adult patients with MMD undergoing STA-MCA bypass. A systematic review was conducted per PRISMA guidelines using MEDLINE and Embase databases through July 2026. Studies included reported perfusion parameters derived from CT perfusion (CTP), comprising relative cerebral blood flow (rCBF), cerebral blood volume (rCBV), mean transit time (rMTT), and time-to-peak (rTTP), as well as postoperative CHS incidence. Included studies reported relative perfusion values and incidence of CHS. A univariate random-effects meta-regression was conducted, as well as a multivariate meta-regression in an expanded cohort sensitivity analysis, which additionally included one dynamic susceptibility contrast (DSC) MR perfusion cohort and one DCU-7 full color Doppler cohort. Among 177 citations screened, 40 underwent full-text review, and five studies representing 379 patients (23 CHS events) met criteria and were included in the primary analysis, with a pooled CHS incidence of 4.9% (95% CI 1.7-9.4%); six additional studies with externally calculated values were included in an expanded-cohort sensitivity analysis only (11 studies, 962 patients). No preoperative, postoperative, or differential parameter was significantly associated with CHS in the primary analysis or in any sensitivity analysis, including the expanded multivariate cohort. No perfusion parameter was reliably associated with CHS in adult patients undergoing STA-MCA bypass for MMD. Future patient-level studies with standardized CHS definitions are necessary before perfusion imaging can be applied clinically in this setting.

Indexed as

Cerebral RevascularizationCerebrovascular CirculationCerebrovascular DisordersMiddle Cerebral ArteryMoyamoya DiseasePostoperative ComplicationsHumansPerfusion ImagingTomography, X-Ray ComputedCerebral hyperperfusion syndromeCerebral revascularizationMeta-analysis as topicMoyamoya diseasePerfusion imaging

Identifiers

PMID42754768

What OpenQuestion holds

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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.