{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,11]],"date-time":"2026-07-11T13:37:07Z","timestamp":1783777027952,"version":"3.55.0"},"reference-count":18,"publisher":"Oxford University Press (OUP)","issue":"1","license":[{"start":{"date-parts":[[2019,10,30]],"date-time":"2019-10-30T00:00:00Z","timestamp":1572393600000},"content-version":"vor","delay-in-days":302,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"funder":[{"name":"Michael Scott Research Endowment Operating Fund"},{"name":"Ingraham Fund for Neurosurgical Research"},{"name":"Sage Schermerhorn Chair for Image-Guided Research"},{"name":"Kids at Heart Fund and the Chae Family Fund"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2019,1,1]]},"abstract":"<jats:title>Abstract<\/jats:title>\n               <jats:p>Moyamoya is a progressive steno-occlusive cerebrovascular pathology of unknown aetiology that usually involves the terminal portions of the internal carotid arteries and\/or the proximal portions of the anterior and middle cerebral arteries bilaterally. The pre-operative Suzuki staging system and post-operative Matsushima grade are nearly universally used markers of natural history and surgical revascularization results, respectively, but their correlation with clinical and radiographic manifestations of moyamoya has not been systematically evaluated in a large cohort. This study evaluated the strength of correlations between pre- and post-operative angiographic parameters and clinical status among paediatric patients with moyamoya. The participants included 58 patients of mean age 11\u2009years at the time of surgery who underwent bilateral indirect revascularization in the same procedure at Boston Children\u2019s Hospital, between January 2010 and December 2015. All included patients had available pre-operative and 1-year post-operative digital subtraction angiography. Clinical data included presenting symptoms, degree of functional incapacity, and peri-operative and long-term complications. Radiographic data included pre-operative Suzuki stage, degree of arterial stenosis, a novel collateral score, the presence of hypovascular territories on digital subtraction angiography, and post-operative Matsushima grade and evolution of stenosis. Chi-squared test and Pearson coefficient were used for correlation studies for categorical variables and Spearman\u2019s rho was used for correlation studies for continuous variables. Results showed that Suzuki stage, collateral score and degree of stenosis were insufficient to predict clinical presentation, pre-operative incapacity and radiographic presentation, whereas the presence of hypovascular territories was correlated with all of these. At 1-year follow-up, Matsushima grade was insufficient for predicting peri-operative or long-term complications, nor did it correlate with post-operative incapacity. The presence of hypovascular territories at 1-year follow-up was correlated with the incidence of post-operative ischaemic symptoms.<\/jats:p>","DOI":"10.1093\/braincomms\/fcz029","type":"journal-article","created":{"date-parts":[[2019,10,30]],"date-time":"2019-10-30T19:14:07Z","timestamp":1572462847000},"source":"Crossref","is-referenced-by-count":31,"title":["Clinical status and evolution in moyamoya: which angiographic findings correlate?"],"prefix":"10.1093","volume":"1","author":[{"given":"Andrea","family":"Rosi","sequence":"first","affiliation":[{"name":"Department of Experimental and Clinical Sciences, Careggi University Hospital, University of Florence, 3 Largo Giovanni Alessandro Brambilla, 50134 Florence, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5073-3606","authenticated-orcid":false,"given":"Coleman P","family":"Riordan","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Boston Children\u2019s Hospital, Harvard Medical School, 300 Longwood Avenue, Boston, MA 02115, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Edward R","family":"Smith","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Boston Children\u2019s Hospital, Harvard Medical School, 300 Longwood Avenue, Boston, MA 02115, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"R Michael","family":"Scott","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Boston Children\u2019s Hospital, Harvard Medical School, 300 Longwood Avenue, Boston, MA 02115, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Darren B","family":"Orbach","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Boston Children\u2019s Hospital, Harvard Medical School, 300 Longwood Avenue, Boston, MA 02115, USA"},{"name":"Neurointerventional Radiology Boston Children\u2019s Hospital, Harvard Medical School, 300 Longwood Avenue, Boston, MA 02115, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"286","published-online":{"date-parts":[[2019,10,30]]},"reference":[{"key":"2020081108573516900_fcz029-B1","doi-asserted-by":"crossref","first-page":"1146","DOI":"10.1212\/WNL.0000000000001969","article-title":"Early-onset bilateral cerebral arteriopathies: cohort study of phenotype and disease course","volume":"85","author":"Al-Yassin","year":"2015","journal-title":"Neurology"},{"key":"2020081108573516900_fcz029-B2","doi-asserted-by":"crossref","first-page":"75","DOI":"10.1159\/000369524","article-title":"Clinical features, surgical treatment, and long-term outcome in pediatric patients with moyamoya disease in China","volume":"39","author":"Bao","year":"2015","journal-title":"Cerebrovasc Dis"},{"key":"2020081108573516900_fcz029-B3","doi-asserted-by":"crossref","first-page":"463","DOI":"10.1159\/000332087","article-title":"Measuring outcome after arterial ischemic stroke in childhood with two different instruments","volume":"32","author":"Bulder","year":"2011","journal-title":"Cerebrovasc Dis"},{"key":"2020081108573516900_fcz029-B4","doi-asserted-by":"crossref","first-page":"189","DOI":"10.2176\/nmc.ra.2014-0307","article-title":"Diagnosis of moyamoya disease: international standard and regional differences","volume":"55","author":"Fujimura","year":"2015","journal-title":"Neurol Med Chir (Tokyo)"},{"key":"2020081108573516900_fcz029-B5","doi-asserted-by":"crossref","first-page":"961","DOI":"10.3171\/2013.6.JNS122099","article-title":"Assessment of the difference in posterior circulation involvement between pediatric and adult patients with moyamoya disease","volume":"119","author":"Hishikawa","year":"2013","journal-title":"J Neurosurg"},{"key":"2020081108573516900_fcz029-B6","first-page":"734","article-title":"How does angiogenesis develop in pediatric moyamoya disease after surgery? A prospective study with MR angiography","volume":"20","author":"Houkin","year":"2004","journal-title":"Childs Nerv Syst"},{"key":"2020081108573516900_fcz029-B7","doi-asserted-by":"crossref","first-page":"350","DOI":"10.1177\/088307380001500512","article-title":"Rational approach to treatment of moyamoya disease in childhood","volume":"15","author":"Ikezaki","year":"2000","journal-title":"J Child Neurol"},{"key":"2020081108573516900_fcz029-B8","doi-asserted-by":"crossref","first-page":"632","DOI":"10.3171\/2018.1.PEDS17367","article-title":"Posterior cerebral artery stenosis and posterior circulation revascularization surgery in pediatric patients with moyamoya disease","volume":"21","author":"Kimiwada","year":"2018","journal-title":"J Neurosurg Pediatr"},{"key":"2020081108573516900_fcz029-B9","doi-asserted-by":"crossref","first-page":"3193","DOI":"10.1161\/STROKEAHA.107.513408","article-title":"Moyamoya disease in Europeans","volume":"39","author":"Kraemer","year":"2008","journal-title":"Stroke"},{"key":"2020081108573516900_fcz029-B11","doi-asserted-by":"crossref","first-page":"436","DOI":"10.3340\/jkns.2015.57.6.436","article-title":"Posterior cerebral artery insufficiency in pediatric moyamoya disease","volume":"57","author":"Lee","year":"2015","journal-title":"J Korean Neurosurg Soc"},{"key":"2020081108573516900_fcz029-B13","first-page":"155","article-title":"Moyamoya disease in children and its surgical treatment. Introduction of a new surgical procedure and its follow-up angiograms","volume":"11","author":"Matsushima","year":"1984","journal-title":"Childs Brain"},{"key":"2020081108573516900_fcz029-B14","doi-asserted-by":"crossref","first-page":"90","DOI":"10.1177\/1747493016669847","article-title":"Moyamoya vasculopathy\u2014patient demographics and characteristics in the Finnish population","volume":"12","author":"Saarela","year":"2017","journal-title":"Int J Stroke"},{"key":"2020081108573516900_fcz029-B15","doi-asserted-by":"crossref","first-page":"1226","DOI":"10.1056\/NEJMra0804622","article-title":"Moyamoya disease and moyamoya syndrome","volume":"360","author":"Scott","year":"2009","journal-title":"N Engl J Med"},{"key":"2020081108573516900_fcz029-B16","first-page":"142","article-title":"Long-term outcome in children with moyamoya syndrome after cranial revascularization by pial synangiosis","volume":"100 (2 Suppl Pediatrics)","author":"Scott","year":"2004","journal-title":"J Neurosurg"},{"key":"2020081108573516900_fcz029-B17","doi-asserted-by":"crossref","first-page":"288","DOI":"10.1001\/archneur.1969.00480090076012","article-title":"Cerebrovascular \u2018moyamoya\u2019 disease. 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