{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,20]],"date-time":"2026-05-20T23:13:02Z","timestamp":1779318782049,"version":"3.51.4"},"reference-count":10,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"4","content-domain":{"domain":["www.ahajournals.org"],"crossmark-restriction":true},"short-container-title":["SVIN"],"published-print":{"date-parts":[[2024,7]]},"abstract":"<jats:sec id=\"svi212915-sec-0010\" xml:lang=\"en\">\n            <jats:title>Background<\/jats:title>\n            <jats:p xml:lang=\"en\">Comorbid conditions may result in symptoms that mimic stroke in children with moyamoya arteriopathy. Health care usage for stroke mimics is not well characterized.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec id=\"svi212915-sec-0020\" xml:lang=\"en\">\n            <jats:title>Methods<\/jats:title>\n            <jats:p xml:lang=\"en\">Consecutive children (aged &lt;18 years) with moyamoya syndrome or disease treated at a single center (2007\u20132021) were identified from a registry. Data including documentation of headache, anxiety, and functional neurologic disorders were retrospectively abstracted using standardized forms. Encounters were attributed to the comorbid condition when (1) related symptoms led to the visit; (2) the condition was documented as the visit diagnosis; and (3) in the absence of stroke, transient ischemic attack, or seizure.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec id=\"svi212915-sec-0030\" xml:lang=\"en\">\n            <jats:title>Results<\/jats:title>\n            <jats:p xml:lang=\"en\">We identified 32 children (63% female) with symptomatic moyamoya arteriopathy diagnosed via imaging at a median age of 7.5 years (range, 0.7\u201317) years, all treated with revascularization surgery. During follow\u2010up (median, 6.7 years after diagnosis [interquartile range, 4.0\u20138.3]), 81% of patients reported headache, 53% reported anxiety, 19% reported panic attacks, and 6% developed a functional neurologic disorder. Both patients with functional neurologic disorder also had migraines and anxiety. In 10 patients (31% of the cohort), a stroke mimic led to 33 emergency department encounters and 9 hospital admissions; 9 received head imaging (magnetic resonance imaging, computed tomography, or computed tomographic angiography) as part of the workup.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec id=\"svi212915-sec-0040\" xml:lang=\"en\">\n            <jats:title>Conclusion<\/jats:title>\n            <jats:p xml:lang=\"en\">Headaches, anxiety, and functional neurologic disorders may mimic stroke symptoms in children with moyamoya arteriopathy, leading to significant health care usage. While providers should remain vigilant for stroke, early recognition of stroke mimics should promote interventions to address comorbid conditions.<\/jats:p>\n          <\/jats:sec>","DOI":"10.1161\/svin.123.001152","type":"journal-article","created":{"date-parts":[[2024,5,16]],"date-time":"2024-05-16T04:47:09Z","timestamp":1715834829000},"update-policy":"https:\/\/doi.org\/10.1161\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":1,"title":["Stroke Mimics in Children With Moyamoya Arteriopathy"],"prefix":"10.1161","volume":"4","author":[{"given":"Ariana J.","family":"Andere","sequence":"first","affiliation":[{"name":"University of California San Francisco","place":["San Francisco, United\u00a0States"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jasmin","family":"Dao","sequence":"additional","affiliation":[{"name":"Adult and Child Neurology Medical Associates","place":["Long Beach, United\u00a0States"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Amy A.","family":"Gelfand","sequence":"additional","affiliation":[{"name":"University of California San Francisco","place":["San Francisco, United\u00a0States"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ramin A.","family":"Morshed","sequence":"additional","affiliation":[{"name":"University of California San Francisco","place":["San Francisco, United\u00a0States"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Alexandra C.","family":"Ross","sequence":"additional","affiliation":[{"name":"University of California San Francisco","place":["San Francisco, United\u00a0States"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Amanda E.","family":"Wagstaff","sequence":"additional","affiliation":[{"name":"University of California San Francisco","place":["San Francisco, United\u00a0States"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Heather J.","family":"Fullerton","sequence":"additional","affiliation":[{"name":"University of California San Francisco","place":["San Francisco, United\u00a0States"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6934-3624","authenticated-orcid":false,"given":"Christine K.","family":"Fox","sequence":"additional","affiliation":[{"name":"University of California San Francisco","place":["San Francisco, United\u00a0States"]}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"276","reference":[{"key":"e_1_3_2_2_2","doi-asserted-by":"publisher","DOI":"10.1212\/01.WNL.0000078894.79866.95"},{"key":"e_1_3_2_3_2","doi-asserted-by":"publisher","DOI":"10.1177\/0883073817718730"},{"key":"e_1_3_2_4_2","doi-asserted-by":"publisher","DOI":"10.1176\/appi.ajp.2018.18040404"},{"key":"e_1_3_2_5_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jocn.2020.07.016"},{"key":"e_1_3_2_6_2","doi-asserted-by":"crossref","DOI":"10.3389\/fped.2022.892445","article-title":"Pediatric moyamoya disease and syndrome in Italy: a multicenter cohort","volume":"10","author":"Po C","year":"2022","unstructured":"Po C, Nosadini M, Zedde M, Pascarella R, Mirone G, Cicala D, Rosati A, Cosi A, Toldo I, Colombatti R, et\u00a0al. Pediatric moyamoya disease and syndrome in Italy: a multicenter cohort. Front Pediatr. 2022;10:892445.","journal-title":"Front Pediatr"},{"key":"e_1_3_2_7_2","doi-asserted-by":"publisher","DOI":"10.3390\/jcm10163628"},{"key":"e_1_3_2_8_2","doi-asserted-by":"publisher","DOI":"10.1111\/j.1469-8749.2009.03527.x"},{"key":"e_1_3_2_9_2","doi-asserted-by":"crossref","first-page":"1683","DOI":"10.1111\/head.13914","article-title":"The effect of psychiatric comorbidities on headache\u2010related disability in migraine: results from the chronic migraine epidemiology and outcomes (CaMEO) study","volume":"60","author":"Lipton RB","year":"2020","unstructured":"Lipton RB, Seng EK, Chu MK, Reed ML, Fanning KM, Adams AM, Buse DC. The effect of psychiatric comorbidities on headache\u2010related disability in migraine: results from the chronic migraine epidemiology and outcomes (CaMEO) study. Headache. 2020;60:1683\u20131696.","journal-title":"Headache"},{"key":"e_1_3_2_10_2","doi-asserted-by":"crossref","first-page":"1107","DOI":"10.1016\/j.jaac.2020.05.005","article-title":"Clinical practice guideline for the assessment and treatment of children and adolescents with anxiety disorders","volume":"59","author":"Walter HJ","year":"2020","unstructured":"Walter HJ, Bukstein OG, Abright AR, Keable H, Ramtekkar U, Ripperger\u2010Suhler J, Rockhill C. Clinical practice guideline for the assessment and treatment of children and adolescents with anxiety disorders. J Am Acad Child Adolesc Psychiatry. 2020;59:1107\u20131124.","journal-title":"J Am Acad Child Adolesc Psychiatry"},{"key":"e_1_3_2_11_2","doi-asserted-by":"crossref","first-page":"349","DOI":"10.1111\/head.13016","article-title":"A systematic review and meta\u2010analysis of the efficacy of cognitive behavioral therapy for the management of pediatric migraine","volume":"57","author":"Ng QX","year":"2017","unstructured":"Ng QX, Venkatanarayanan N, Kumar L. A systematic review and meta\u2010analysis of the efficacy of cognitive behavioral therapy for the management of pediatric migraine. Headache J Head Face Pain. 2017;57:349\u2013362.","journal-title":"Headache J Head Face Pain"}],"container-title":["Stroke: Vascular and Interventional Neurology"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.ahajournals.org\/doi\/full\/10.1161\/SVIN.123.001152","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,5,19]],"date-time":"2025-05-19T11:28:00Z","timestamp":1747654080000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.ahajournals.org\/doi\/10.1161\/SVIN.123.001152"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2024,7]]},"references-count":10,"journal-issue":{"issue":"4","published-print":{"date-parts":[[2024,7]]}},"alternative-id":["10.1161\/SVIN.123.001152"],"URL":"https:\/\/doi.org\/10.1161\/svin.123.001152","relation":{},"ISSN":["2694-5746"],"issn-type":[{"value":"2694-5746","type":"electronic"}],"subject":[],"published":{"date-parts":[[2024,7]]},"assertion":[{"value":"2023-09-30","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2024-03-18","order":2,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2024-05-15","order":3,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}],"article-number":"e001152"}}