{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,7,30]],"date-time":"2025-07-30T14:54:38Z","timestamp":1753887278592,"version":"3.41.2"},"reference-count":38,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"5","content-domain":{"domain":["www.ahajournals.org"],"crossmark-restriction":true},"short-container-title":["SVIN"],"published-print":{"date-parts":[[2024,9]]},"abstract":"<jats:sec xml:lang=\"en\">\n            <jats:title>Background<\/jats:title>\n            <jats:p xml:lang=\"en\">Children with moyamoya arteriopathy have reduced subsequent ischemic risk after revascularization surgery and it is also suggested that hemorrhagic risk may also be reduced by minimizing hemodynamic stress on collateral vasculature recruited within the brain parenchyma, but this has been studied only in intermediate follow\u2010up or follow\u2010up for more than a decade in East Asian populations. We aimed to evaluate the incidence of hemorrhagic stroke in long\u2010term follow\u2010up and identify at\u2010risk subpopulations.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec xml:lang=\"en\">\n            <jats:title>Methods<\/jats:title>\n            <jats:p xml:lang=\"en\">A single surgeon's personal case series with decades of follow\u2010up was reviewed for children (18 years or younger) treated with revascularization surgery. This included medical records and the surgeon's personal correspondence.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec xml:lang=\"en\">\n            <jats:title>Results<\/jats:title>\n            <jats:p xml:lang=\"en\">Hemorrhagic stroke occurred in 2.6% of 302 children followed for a median of 21 years after surgery. Occurring at a median of 19 years (interquartile range 14\u201322.75) after surgery, these hemorrhages would not be recognized in series that discontinue follow\u2010up at transition from pediatric to adult neurosurgical care. There was a higher proportion (5.5\u2010fold hazard, 95% CI, 1.1\u201327.6) of patients who had prior radiation therapy in the group with hemorrhagic stroke compared with the overall group. Close retrospective evaluation of vascular imaging suggests aneurysms of the collateral periventricular vessels as a common culprit.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec xml:lang=\"en\">\n            <jats:title>Conclusion<\/jats:title>\n            <jats:p xml:lang=\"en\">Children who have moyamoya treated with revascularization surgery remain at long\u2010term risk of hemorrhagic stroke during adulthood, even though their ischemic stroke risk is significantly mitigated. These patients would benefit from continued clinical and radiological follow\u2010up, potentially with advanced imaging modalities.<\/jats:p>\n          <\/jats:sec>","DOI":"10.1161\/svin.124.001348","type":"journal-article","created":{"date-parts":[[2024,7,2]],"date-time":"2024-07-02T06:29:23Z","timestamp":1719901763000},"update-policy":"https:\/\/doi.org\/10.1161\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":0,"title":["Long\u2010Term Hemorrhagic Morbidity for Children With Moyamoya Treated With Revascularization Surgery in a Single Center Retrospective Cohort"],"prefix":"10.1161","volume":"4","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-3634-4692","authenticated-orcid":false,"given":"Alfred P.","family":"See","sequence":"first","affiliation":[{"name":"Department of Neurosurgery Boston Children's Hospital, Harvard Medical School Boston MA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8322-109X","authenticated-orcid":false,"given":"Sophia D.","family":"Kocher","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery Boston Children's Hospital, Harvard Medical School Boston MA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7548-196X","authenticated-orcid":false,"given":"Paulina","family":"Piwowarczyk","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery Boston Children's Hospital, Harvard Medical School Boston MA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9246-4184","authenticated-orcid":false,"given":"Sanda","family":"Alexandrescu","sequence":"additional","affiliation":[{"name":"Department of Pathology Boston Children's Hospital, Harvard Medical School  Boston MA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7733-600X","authenticated-orcid":false,"given":"Keith L.","family":"Ligon","sequence":"additional","affiliation":[{"name":"Department of Pathology Boston Children's Hospital, Harvard Medical School  Boston MA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1793-3398","authenticated-orcid":false,"given":"Darren B.","family":"Orbach","sequence":"additional","affiliation":[{"name":"Department of Radiology Boston Children's Hospital, Harvard Medical School Boston MA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6317-8450","authenticated-orcid":false,"given":"Edward R.","family":"Smith","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery Boston Children's Hospital, Harvard Medical School Boston MA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6007-0356","authenticated-orcid":false,"given":"Laura L.","family":"Lehman","sequence":"additional","affiliation":[{"name":"Department of Neurology Boston Children's Hospital, Harvard Medical School Boston MA"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"276","reference":[{"key":"e_1_3_2_2_2","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMra0804622"},{"key":"e_1_3_2_3_2","doi-asserted-by":"publisher","DOI":"10.1007\/s00701-013-1975-7"},{"key":"e_1_3_2_4_2","doi-asserted-by":"crossref","first-page":"568","DOI":"10.2176\/nmc.50.568","article-title":"Fusiform aneurysm associated with fenestration of the posterior communicating artery \u2010 case report","volume":"50","author":"Baba S","year":"2010","unstructured":"Baba S, Fukuda Y, Mizota S, Hayashi K, Suyama K, Nagata I. 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