{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,21]],"date-time":"2026-09-21T01:39:22Z","timestamp":1789954762468,"version":"4.0.1"},"reference-count":63,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"7","content-domain":{"domain":["www.ahajournals.org"],"crossmark-restriction":true},"short-container-title":["Stroke"],"published-print":{"date-parts":[[1998,7]]},"abstract":"<jats:p>\n            <jats:italic>Background and Purpose<\/jats:italic>\n            \u2014We report the clinical features and longitudinal outcome of the largest cohort of patients with moyamoya disease described from a single institution in the western hemisphere. Moyamoya disease in Asia usually presents with ischemic stroke in children and intracranial hemorrhage in adults.\n          <\/jats:p>\n          <jats:p>\n            <jats:italic>Methods<\/jats:italic>\n            \u2014Our study population included all patients with moyamoya disease evaluated at a university hospital in Houston, Texas from 1985 through 1995 (n=35). We used Kaplan-Meier methods to estimate individual and hemispheric stroke risk by treatment status (medical versus surgical). Predictors of neurological outcome were assessed.\n          <\/jats:p>\n          <jats:p>\n            <jats:italic>Results<\/jats:italic>\n            \u2014The ethnic background of our patients was representative of the general population in Texas. The mean age at diagnosis was 32 years (range, 6 to 59 years). Ischemic stroke or transient ischemic attack was the predominant initial symptom in both adults and children. Of the 6 patients with intracranial hemorrhage, 5 had an intraventricular site of hemorrhage. The crude stroke recurrence rate was 10.3% per year in 116 patient-years of follow-up. Twenty patients underwent surgical revascularization, the most common procedure being encephaloduroarteriosynangiosis. The 5-year risk of ipsilateral stroke after synangiosis was 15%, compared with 20% for medical treatment and 22% overall for surgery.\n          <\/jats:p>\n          <jats:p>\n            <jats:italic>Conclusions<\/jats:italic>\n            \u2014Our observations indicate that moyamoya disease may have a different clinical expression in the United States than in Asia, and may demonstrate a trend toward a lower stroke recurrence rate and better functional outcome after synangiosis.\n          <\/jats:p>","DOI":"10.1161\/01.str.29.7.1347","type":"journal-article","created":{"date-parts":[[2011,6,17]],"date-time":"2011-06-17T20:08:03Z","timestamp":1308341283000},"page":"1347-1351","update-policy":"https:\/\/doi.org\/10.1161\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":240,"title":["Clinical Features of Moyamoya Disease in the United States"],"prefix":"10.1161","volume":"29","author":[{"given":"David","family":"Chiu","sequence":"first","affiliation":[{"name":"From the Department of Neurology, Baylor College of Medicine (D.C.), The Greater Houston Neurosurgery Center (P.S.), and the Department of Neurology, University of Texas Houston Health Sciences Center (P.B., J.C.G.), Houston, Tex."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Peter","family":"Shedden","sequence":"additional","affiliation":[{"name":"From the Department of Neurology, Baylor College of Medicine (D.C.), The Greater Houston Neurosurgery Center (P.S.), and the Department of Neurology, University of Texas Houston Health Sciences Center (P.B., J.C.G.), Houston, Tex."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Patti","family":"Bratina","sequence":"additional","affiliation":[{"name":"From the Department of Neurology, Baylor College of Medicine (D.C.), The Greater Houston Neurosurgery Center (P.S.), and the Department of Neurology, University of Texas Houston Health Sciences Center (P.B., J.C.G.), Houston, Tex."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"James C.","family":"Grotta","sequence":"additional","affiliation":[{"name":"From the Department of Neurology, Baylor College of Medicine (D.C.), The Greater Houston Neurosurgery Center (P.S.), and the Department of Neurology, University of Texas Houston Health Sciences Center (P.B., J.C.G.), Houston, Tex."}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"276","reference":[{"key":"e_1_3_1_1_2","first-page":"37","volume":"9","year":"1957","unstructured":"Takeuchi K, Shimizu K. 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