Moyamoya disease

Treatment

Mayo Clinic doctors trained in brain conditions (neurologists) and brain surgery (neurosurgeons) work together to treat people with moyamoya disease.

Doctors will evaluate your condition and determine the most appropriate treatment for your condition. The goal of treatment is to reduce your symptoms, improve your blood flow and lower your risk of serious complications such as strokes, bleeding in your brain (intracerebral hemorrhages) or death.

Your treatment may include:

Revascularization surgery

In revascularization surgery, surgeons bypass blocked arteries to help restore blood flow to your brain. Mayo Clinic doctors may use direct or indirect revascularization procedures, or a combination of both.

Direct revascularization procedure

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• Direct revascularization procedures. In direct revascularization surgery, surgeons attach (suture) the scalp artery directly to a brain artery (superficial temporal artery to middle cerebral artery surgery) to increase blood flow to your brain immediately. Direct bypass surgery may be difficult to perform in children, due to the small blood vessels that need to be attached.
• Indirect revascularization procedures. Indirect revascularization includes several options.
  
  In encephaloduroarteriosynangiosis (EDAS), your surgeon separates (dissects) a scalp artery over several inches. Your surgeon makes a small temporary opening in your skull directly beneath the artery and attaches (sutures) the intact scalp artery to the surface of your brain, which allows blood vessels from the artery to grow into your brain over time. The surgeon then replaces the bone and closes the opening in your skull.
  
  
  

  EDAS indirect revascularization procedure

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  In encephalomyosynangiosis (EMS), your surgeon separates (dissects) a muscle in the temple region of your forehead and places it onto the surface of your brain through an opening in your skull to help restore blood flow.
  
  Sometimes your surgeon may perform EMS with EDAS. In this procedure, your surgeon separates (dissects) a muscle in the temple region of your forehead and places it onto the surface of your brain (EMS), after attaching the scalp artery to the surface of your brain (EDAS). The muscle helps to hold the artery in place as blood vessels grow into your brain over time.
  
  
  

  EDAS with EMS indirect revascularization procedures

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  Your surgeon may make multiple holes (burr holes) into your skull to allow new blood vessels to grow, either as a separate procedure or in combination with other procedures.
  
  Your doctor may use other combinations of direct and indirect revascularization procedures depending on your needs.