{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,11]],"date-time":"2026-07-11T13:10:08Z","timestamp":1783775408896,"version":"3.55.0"},"reference-count":29,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"8","content-domain":{"domain":["www.ahajournals.org"],"crossmark-restriction":true},"short-container-title":["Stroke"],"published-print":{"date-parts":[[1996,8]]},"abstract":"<jats:p>\n            <jats:italic>Background and Purpose<\/jats:italic>\n            It is well recognized that revascularization surgery using direct and\/or indirect bypass provides effective surgical management for pediatric moyamoya disease. However, surgical treatment of the adult hemorrhagic type remains controversial. In this study, the effect of surgery for adult moyamoya disease was investigated.\n          <\/jats:p>\n          <jats:p>\n            <jats:italic>Methods<\/jats:italic>\n            We analyzed 35 patients with adult moyamoya disease (patient age, over 20 years), 24 patients with initial onset of intracerebral hemorrhage, and 11 patients with initial onset of cerebral ischemia who underwent both direct bypass surgery of the superficial temporal artery to the middle cerebral artery anastomosis and indirect revascularization of encephalo-duro-arterio-myo-synangiosis.\n          <\/jats:p>\n          <jats:p>\n            <jats:italic>Results<\/jats:italic>\n            Of 24 patients with hemorrhagic-type disease, 3 showed rebleeding; of 11 patients with the ischemic type, 2 showed intracerebral hemorrhage after surgery. Overall, 5 of 35 patients (14.3%) had hemorrhage after revascularization surgery (mean follow-up period, 6.4 years). Postoperative angiography revealed that direct anastomosis is effective whereas indirect revascularization is not always effective for adult moyamoya disease. Moyamoya vessels, which are supposed to be responsible for hemorrhage, decreased in 25% of patients.\n          <\/jats:p>\n          <jats:p>\n            <jats:italic>Conclusions<\/jats:italic>\n            Revascularization surgery cannot always prevent rebleeding. However, a decrease in moyamoya vessels was induced by surgery, which may reduce the risk of hemorrhage more effectively than conservative treatment. In cases of adult moyamoya disease, direct bypass is particularly important, since the indirect revascularization is not as useful in adult cases as in pediatric cases.\n          <\/jats:p>","DOI":"10.1161\/01.str.27.8.1342","type":"journal-article","created":{"date-parts":[[2011,6,17]],"date-time":"2011-06-17T20:08:03Z","timestamp":1308341283000},"page":"1342-1346","update-policy":"https:\/\/doi.org\/10.1161\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":178,"title":["Surgical Therapy for Adult Moyamoya Disease"],"prefix":"10.1161","volume":"27","author":[{"given":"Kiyohiro","family":"Houkin","sequence":"first","affiliation":[{"name":"the Department of Neurosurgery, Hokkaido University School of Medicine, Sapporo, Japan."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hiroyasu","family":"Kamiyama","sequence":"additional","affiliation":[{"name":"the Department of Neurosurgery, Hokkaido University School of Medicine, Sapporo, Japan."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hiroshi","family":"Abe","sequence":"additional","affiliation":[{"name":"the Department of Neurosurgery, Hokkaido University School of Medicine, Sapporo, Japan."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Akihiro","family":"Takahashi","sequence":"additional","affiliation":[{"name":"the Department of Neurosurgery, Hokkaido University School of Medicine, Sapporo, Japan."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Satoshi","family":"Kuroda","sequence":"additional","affiliation":[{"name":"the Department of Neurosurgery, Hokkaido University School of Medicine, Sapporo, Japan."}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"276","reference":[{"key":"e_1_3_2_1_2","doi-asserted-by":"publisher","DOI":"10.1161\/str.14.1.6823678"},{"key":"e_1_3_2_2_2","first-page":"750","volume":"20","year":"1976","unstructured":"Kudo T, Fukuda S. Spontaneous occlusion of the circle of Willis: a disease entity, its pathology and clinical features [in Japanese]. Adv Neurol Sci. 1976;20:750-757.","journal-title":"Adv Neurol Sci"},{"key":"e_1_3_2_3_2","doi-asserted-by":"publisher","DOI":"10.2176\/nmc.17pt1.29"},{"key":"e_1_3_2_4_2","doi-asserted-by":"publisher","DOI":"10.3171\/jns.1978.49.5.0679"},{"key":"e_1_3_2_5_2","first-page":"444","volume":"14","year":"1980","unstructured":"Karasawa J, Kikuchi H, Kawamura J, Sakaki T. Intracranial transplantation of the omentum for cerebrovascular moyamoya disease: a two-year follow-up study. Surg Neurol. 1980;14:444-449.","journal-title":"Surg Neurol"},{"key":"e_1_3_2_6_2","doi-asserted-by":"crossref","unstructured":"Kikuchi H Karasawa J. Extracranial-intracranial arterial anastomosis in ten patients with moyamoya syndrome. In: Schmiedek P ed. Microsurgery for Stroke. Heidelberg Germany: Springer-Verlag; 1976:260-263.","DOI":"10.1007\/978-1-4612-6349-4_36"},{"key":"e_1_3_2_7_2","doi-asserted-by":"publisher","DOI":"10.1227\/00006123-199304000-00006"},{"key":"e_1_3_2_8_2","first-page":"1559","volume":"14","year":"1986","unstructured":"Matsushima Y, Suzuki R, Yamaguchi T, Tabata H, Inaba Y. Effect of indirect EC\/IC bypass operation on adult moyamoya patients [in Japanese]. No Shinkei Geka. 1986;14:1559-1566.","journal-title":"No Shinkei Geka"},{"key":"e_1_3_2_9_2","doi-asserted-by":"crossref","unstructured":"Nakagawa Y Abe H Kamiyama H Sawamura Y Gotoh S Kashiwaba T. Revascularization surgery for 50 patients with moyamoya disease. In: Suzuki J ed. Advances in Surgery for Cerebral Stroke. 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AJNR Am J Neuroradiol. 1993;14:29-30.","journal-title":"AJNR Am J Neuroradiol"},{"key":"e_1_3_2_29_2","doi-asserted-by":"publisher","DOI":"10.1016\/0304-3940(93)90416-I"}],"container-title":["Stroke"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.ahajournals.org\/doi\/full\/10.1161\/01.STR.27.8.1342","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2024,5,12]],"date-time":"2024-05-12T22:39:50Z","timestamp":1715553590000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.ahajournals.org\/doi\/10.1161\/01.STR.27.8.1342"}},"subtitle":["Can Surgical Revascularization Prevent the Recurrence of Intracerebral Hemorrhage?"],"short-title":[],"issued":{"date-parts":[[1996,8]]},"references-count":29,"journal-issue":{"issue":"8","published-print":{"date-parts":[[1996,8]]}},"alternative-id":["10.1161\/01.STR.27.8.1342"],"URL":"https:\/\/doi.org\/10.1161\/01.str.27.8.1342","relation":{},"ISSN":["0039-2499","1524-4628"],"issn-type":[{"value":"0039-2499","type":"print"},{"value":"1524-4628","type":"electronic"}],"subject":[],"published":{"date-parts":[[1996,8]]},"assertion":[{"value":"1996-03-04","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"1996-04-09","order":1,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"1996-08-01","order":2,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}]}}