{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,29]],"date-time":"2026-08-29T13:40:00Z","timestamp":1788010800419,"version":"build-2784847793"},"reference-count":35,"publisher":"Wiley","issue":"10","license":[{"start":{"date-parts":[[2025,10,2]],"date-time":"2025-10-02T00:00:00Z","timestamp":1759363200000},"content-version":"vor","delay-in-days":1,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100000780","name":"European Commission","doi-asserted-by":"publisher","award":["PNRR\u2010MR1 2022\u201012376618"],"award-info":[{"award-number":["PNRR\u2010MR1 2022\u201012376618"]}],"id":[{"id":"10.13039\/501100000780","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100003196","name":"Ministero della Salute","doi-asserted-by":"publisher","award":["RC\u2010ZLDS 2024\u20102025"],"award-info":[{"award-number":["RC\u2010ZLDS 2024\u20102025"]}],"id":[{"id":"10.13039\/501100003196","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Euro J of Neurology"],"published-print":{"date-parts":[[2025,10]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Moyamoya angiopathy (MMA) is a rare, progressive cerebrovascular disorder characterized by stenosis or occlusion of the terminal internal carotid arteries, leading to the development of fragile collateral vessels. Headache is a common but understudied symptom of MMA, reported in up to 75% of patients. The headache phenotype often mimics migraine or tension\u2010type headache, although cluster headache\u2010like episodes have also been described. Aims to summarize current evidence on the clinical characteristics, underlying mechanisms, and treatment strategies for headache in MMA.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Materials and Methods<\/jats:title>\n                    <jats:p>A narrative review of the literature was conducted, focusing on the prevalence, phenotype, pathophysiological mechanisms, and therapeutic options for headache in MMA.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>The pathogenesis of headache in MMA remains unclear but is likely multifactorial, involving impaired cerebrovascular autoregulation, microvascular ischemia, and collateral vessel development. No standardized treatment exists for MMA\u2010related headache. Antiplatelet therapy, particularly aspirin, may offer some benefit, whereas NSAIDs and triptans require caution due to cerebrovascular risks. Emerging therapies such as calcitonin gene\u2010related peptide (CGRP) inhibitors and Lasmiditan show potential but lack specific data in MMA patients. Surgical revascularization, mainly through direct or combined bypass, is an established intervention for stroke prevention and may also reduce headache burden. However, postoperative outcomes are heterogeneous, with reports of both headache improvement and new\u2010onset headache.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Discussion and Conclusion<\/jats:title>\n                    <jats:p>Headache is a frequent and clinically relevant manifestation of MMA that significantly impacts quality of life. Evidence on optimal management remains scarce, and current strategies are largely empirical. Further studies are needed to clarify pathogenic mechanisms, refine patient selection for surgical interventions, and evaluate pharmacological treatments, including novel agents, to improve clinical outcomes.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/ene.70316","type":"journal-article","created":{"date-parts":[[2025,10,3]],"date-time":"2025-10-03T05:49:27Z","timestamp":1759470567000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":3,"title":["The Spectrum of Headaches in Moyamoya Angiopathy: From Mechanisms to Management Strategies\u2014A Consensus Review From the\n                    <scp>NEUROVASC<\/scp>\n                    Working Group"],"prefix":"10.1111","volume":"32","author":[{"given":"Nicola","family":"Rifino","sequence":"first","affiliation":[{"name":"Cerebrovascular Unit Fondazione IRCCS Istituto Neurologico Carlo Besta  Milan Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2824-2760","authenticated-orcid":false,"given":"Anne Hege","family":"Aamodt","sequence":"additional","affiliation":[{"name":"Department of Neurology Oslo University Hospital  Oslo Norway"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Markus","family":"Wiedmann","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery Oslo University Hospital  Oslo Norway"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Markus","family":"Kramer","sequence":"additional","affiliation":[{"name":"Department of Neurology Alfried Krupp Hospital  Essen Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jana","family":"Becker","sequence":"additional","affiliation":[{"name":"Department of Neurology Alfried Krupp Hospital  Essen Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"St\u00e9phanie","family":"Guey","sequence":"additional","affiliation":[{"name":"CNVT\u2010CERVCO et D\u00e9partement de Neurologie H\u00f4pital Lariboisi\u00e8re, APHP Nord  Paris France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4063-3924","authenticated-orcid":false,"given":"Francesco","family":"Acerbi","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery Fondazione IRCCS Istituto Neurologico Carlo Besta  Milan Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Dominique","family":"Herve","sequence":"additional","affiliation":[{"name":"CNVT\u2010CERVCO et D\u00e9partement de Neurologie H\u00f4pital Lariboisi\u00e8re, APHP Nord  Paris France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Anna","family":"Bersano","sequence":"additional","affiliation":[{"name":"Cerebrovascular Unit Fondazione IRCCS Istituto Neurologico Carlo Besta  Milan Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2025,10,2]]},"reference":[{"key":"e_1_2_9_2_1","doi-asserted-by":"publisher","DOI":"10.1136\/jnnp.2007.130666"},{"key":"e_1_2_9_3_1","doi-asserted-by":"publisher","DOI":"10.1016\/S1474-4422(22)00165-X"},{"key":"e_1_2_9_4_1","doi-asserted-by":"publisher","DOI":"10.1177\/23969873221144089"},{"key":"e_1_2_9_5_1","doi-asserted-by":"publisher","DOI":"10.1159\/000442298"},{"key":"e_1_2_9_6_1","doi-asserted-by":"publisher","DOI":"10.3389\/fneur.2020.605636"},{"key":"e_1_2_9_7_1","doi-asserted-by":"publisher","DOI":"10.1177\/03331024211056250"},{"key":"e_1_2_9_8_1","first-page":"439","article-title":"Headache in Pediatric Moyamoya Disease: Review of 204 Consecutive Cases","volume":"103","author":"Seol H. 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