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In particular, evidence on the disease history and management of MMA is lacking, mainly due to methodological and selection biases in the available studies and the lack of large, randomized prospective studies. Therefore, the care of MMA patients remains limited to a few expert centers worldwide, and management is often based on local expertise and available resources. Over the years, recommendations or expert opinions have been written to provide guidance to physicians in the treatment of this condition with the goal of reducing the risk of stroke recurrence and long-term disability. However, there is no complete agreement between the available guidelines and recommendations due to differences in the articles addressed, methodologies, expertise, and validated approaches to literature review. This lack of consensus on the management of MMA may confuse clinicians and highlight some important issues and points. The aim of this comprehensive review article is to critically examine three recent guidelines and recommendations on MMA, discussing their differences and similarities and highlighting gaps in MMA care that need to be covered.<\/jats:p>","DOI":"10.1177\/17474930241297031","type":"journal-article","created":{"date-parts":[[2024,10,19]],"date-time":"2024-10-19T07:45:36Z","timestamp":1729323936000},"page":"512-523","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":17,"title":["Diagnosis and management of adult Moyamoya angiopathy: An overview of guideline recommendations and identification of future research directions"],"prefix":"10.1177","volume":"20","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-0423-8759","authenticated-orcid":false,"given":"Nicola","family":"Rifino","sequence":"first","affiliation":[{"name":"Cerebrovascular Unit, Fondazione IRCCS Istituto Neurologico Carlo Besta, Milan, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Dominique","family":"Herv\u00e8","sequence":"additional","affiliation":[{"name":"CNVT-CERVCO et d\u00e9partement de Neurologie, H\u00f4pital Lariboisi\u00e8re, APHP Nord, Paris, France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"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":"Satoshi","family":"Kuroda","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Graduate School of Medicine and Pharmaceutical Sciences, University of Toyama, Toyama, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Giuseppe","family":"Lanzino","sequence":"additional","affiliation":[{"name":"Department of Neurological Surgery, Mayo Clinic, Rochester, MN, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Peter","family":"Vajkoczy","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Charit\u00e9 Universit\u00e4tsmedizin Berlin, Berlin, Germany"}],"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":"179","published-online":{"date-parts":[[2024,11,4]]},"reference":[{"key":"e_1_3_2_2_2","doi-asserted-by":"publisher","DOI":"10.1136\/jnnp.2007.130666"},{"key":"e_1_3_2_3_2","doi-asserted-by":"publisher","DOI":"10.1001\/archneur.1969.00480090076012"},{"key":"e_1_3_2_4_2","doi-asserted-by":"publisher","DOI":"10.1016\/S1474-4422(08)70240-0"},{"key":"e_1_3_2_5_2","doi-asserted-by":"publisher","DOI":"10.1016\/S1474-4422(22)00165-X"},{"key":"e_1_3_2_6_2","doi-asserted-by":"publisher","DOI":"10.1159\/000442298"},{"key":"e_1_3_2_7_2","doi-asserted-by":"publisher","DOI":"10.1177\/23969873221144089"},{"key":"e_1_3_2_8_2","doi-asserted-by":"publisher","DOI":"10.2176\/jns-nmc.2021-0382"},{"key":"e_1_3_2_9_2","doi-asserted-by":"publisher","DOI":"10.2176\/jns-nmc.2022-0072"},{"key":"e_1_3_2_10_2","doi-asserted-by":"publisher","DOI":"10.1161\/STR.0000000000000443"},{"key":"e_1_3_2_11_2","doi-asserted-by":"publisher","DOI":"10.1016\/S0303-8467(97)00082-6"},{"key":"e_1_3_2_12_2","first-page":"37","article-title":"Hypogenesis of bilateral internal carotid arteries","volume":"9","author":"Takeuchi K","year":"1957","unstructured":"Takeuchi K, Shimizu K. 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