{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,1,19]],"date-time":"2026-01-19T01:24:44Z","timestamp":1768785884888,"version":"3.49.0"},"reference-count":19,"publisher":"Scientific Scholar","content-domain":{"domain":["surgicalneurologyint.com"],"crossmark-restriction":true},"short-container-title":[],"abstract":"\nBackground: <\/jats:title>\nMoyamoya disease often presents white matter hyperintensity (WMH) lesions on fluid-attenuated inversion recovery (FLAIR) images, which is generally accepted as irreversible. We, herein, describe three cases of moyamoya disease with WMH lesions that regressed or disappeared after surgical revascularization.<\/jats:p>\n<\/jats:sec>\n\nCase Description: <\/jats:title>\nThis report included two pediatric and one young adult case that developed transient ischemic attacks or ischemic stroke due to bilateral Moyamoya disease. Before surgery, five of their six hemispheres had WMH lesions in the subcortical and\/or periventricular white matter on FLAIR images. The lesions included morphologically two different patterns: \u201cStriated\u201d and \u201cpatchy\u201d morphology. In all of them, combined bypass surgery was successfully performed on both sides, and no cerebrovascular events occurred during follow-up periods. On follow-up magnetic resonance examinations, the \u201cstriated\u201d WMH lesions completely disappeared within six months, while the \u201cpatchy\u201d WMH lesions slowly regressed over 12 months.<\/jats:p>\n<\/jats:sec>\n\nConclusion: <\/jats:title>\nBased on radiological findings and the postoperative course of the WMH lesions, the \u201cstriated\u201d WMH lesions may represent the inflammation or edema along the neuronal axons due to cerebral ischemia, while the \u201cpatchy\u201d WMH lesions may represent vasogenic edema in the white matter through the blood-brain barrier breakdown. Earlier surgical revascularization may resolve these WMH lesions in Moyamoya disease.<\/jats:p>\n<\/jats:sec>","DOI":"10.25259\/sni_173_2024","type":"journal-article","created":{"date-parts":[[2024,4,12]],"date-time":"2024-04-12T09:25:56Z","timestamp":1712913956000},"page":"131","update-policy":"https:\/\/doi.org\/10.25259\/crossmark_policy","source":"Crossref","is-referenced-by-count":2,"title":["Resolution of white matter hyperintensity after surgical revascularization in moyamoya disease \u2013 A report of three cases"],"prefix":"10.25259","volume":"15","author":[{"given":"Yuichiro","family":"Koga","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Shusuke","family":"Yamamoto","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Satoshi","family":"Kuroda","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"10894","published-online":{"date-parts":[[2024,4,12]]},"reference":[{"key":"10.25259\/SNI_173_2024\/ref-1","doi-asserted-by":"crossref","first-page":"89","DOI":"10.1016\/j.pediatrneurol.2023.03.005","article-title":"Diffusion-weighted magnetic resonance imaging demonstrates white matter alterations in watershed regions in children with moyamoya without stroke or silent infarct","volume":"143","author":"Ahtam","year":"2023","journal-title":"Pediatr Neurol"},{"key":"10.25259\/SNI_173_2024\/ref-2","doi-asserted-by":"crossref","first-page":"591","DOI":"10.1136\/jnnp-2011-301388","article-title":"Executive dysfunction in adults with moyamoya disease is associated with increased diffusion in frontal white matter","volume":"83","author":"Calviere","year":"2012","journal-title":"J Neurol Neurosurg Psychiatry"},{"key":"10.25259\/SNI_173_2024\/ref-3","doi-asserted-by":"crossref","first-page":"2605","DOI":"10.1007\/s00381-020-04854-6","article-title":"Partially reversible confluent white matter lesions in a Caucasian child with moyamoya disease","volume":"36","author":"Geraldo","year":"2020","journal-title":"Childs Nerv Syst"},{"key":"10.25259\/SNI_173_2024\/ref-4","first-page":"1618","article-title":"Myelin and Axonal damage in normal-appearing white matter in patients with moyamoya disease","volume":"41","author":"Hara","year":"2020","journal-title":"AJNR Am J Neuroradiol"},{"key":"10.25259\/SNI_173_2024\/ref-5","doi-asserted-by":"crossref","first-page":"247","DOI":"10.2463\/mrms.ci.2018-0088","article-title":"Regression of white matter hyperintensity after indirect bypass surgery in a patient with moyamoya disease","volume":"18","author":"Hara","year":"2019","journal-title":"Magn Reson Med Sci"},{"key":"10.25259\/SNI_173_2024\/ref-6","doi-asserted-by":"crossref","first-page":"233","DOI":"10.3171\/jns.2001.94.2.0233","article-title":"High-field magnetic resonance imaging in patients with moyamoya disease","volume":"94","author":"Harada","year":"2001","journal-title":"J Neurosurg"},{"key":"10.25259\/SNI_173_2024\/ref-7","doi-asserted-by":"crossref","first-page":"1893","DOI":"10.3174\/ajnr.A2683","article-title":"Changes in integrity of normal-appearing white matter in patients with moyamoya disease: A diffusion tensor imaging study","volume":"32","author":"Jeong","year":"2011","journal-title":"AJNR Am J Neuroradiol"},{"key":"10.25259\/SNI_173_2024\/ref-8","doi-asserted-by":"crossref","first-page":"654","DOI":"10.1016\/j.wneu.2015.11.100","article-title":"Investigating brain network characteristics interrupted by covert white matter injury in patients with moyamoya disease: Insights from graph theoretical analysis","volume":"89","author":"Kazumata","year":"2016","journal-title":"World Neurosurg"},{"key":"10.25259\/SNI_173_2024\/ref-9","doi-asserted-by":"crossref","first-page":"1495","DOI":"10.1016\/j.jstrokecerebrovasdis.2016.02.035","article-title":"Reversibility of white matter hyperintensity by revascularization surgery in moyamoya disease","volume":"25","author":"Komatsu","year":"2016","journal-title":"J Stroke Cerebrovasc Dis"},{"key":"10.25259\/SNI_173_2024\/ref-10","doi-asserted-by":"crossref","first-page":"1056","DOI":"10.1016\/S1474-4422(08)70240-0","article-title":"Moyamoya disease: Current concepts and future perspectives","volume":"7","author":"Kuroda","year":"2008","journal-title":"Lancet Neurol"},{"key":"10.25259\/SNI_173_2024\/ref-11","doi-asserted-by":"crossref","first-page":"1093","DOI":"10.1227\/01.NEU.0000369606.00861.91","article-title":"Novel bypass surgery for moyamoya disease using pericranial flap: Its impacts on cerebral hemodynamics and long-term outcome","volume":"66","author":"Kuroda","year":"2010","journal-title":"Neurosurgery"},{"key":"10.25259\/SNI_173_2024\/ref-12","doi-asserted-by":"crossref","first-page":"909","DOI":"10.3171\/2019.12.JNS192938","article-title":"Late (5-20 years) outcomes after STA-MCA anastomosis and encephalo-duro-myo-arteriopericranial synangiosis in patients with moyamoya disease","volume":"134","author":"Kuroda","year":"2020","journal-title":"J Neurosurg"},{"key":"10.25259\/SNI_173_2024\/ref-13","doi-asserted-by":"crossref","first-page":"197","DOI":"10.1007\/s00381-019-04391-x","article-title":"A rare case of pediatric moyamoya disease with reversible white matter lesions in a 3-year-old Chinese girl","volume":"36","author":"Li","year":"2020","journal-title":"Childs Nerv Syst"},{"key":"10.25259\/SNI_173_2024\/ref-14","doi-asserted-by":"crossref","first-page":"457","DOI":"10.1016\/j.jstrokecerebrovasdis.2013.03.022","article-title":"Executive function and diffusion in frontal white matter of adults with moyamoya disease","volume":"23","author":"Nakamizo","year":"2014","journal-title":"J Stroke Cerebrovasc Dis"},{"key":"10.25259\/SNI_173_2024\/ref-15","doi-asserted-by":"crossref","first-page":"560","DOI":"10.3171\/2017.1.PEDS16541","article-title":"Pathophysiological consideration of medullary streaks on FLAIR imaging in pediatric moyamoya disease","volume":"19","author":"Suzuki","year":"2017","journal-title":"J Neurosurg Pediatr"},{"key":"10.25259\/SNI_173_2024\/ref-16","doi-asserted-by":"crossref","first-page":"288","DOI":"10.1001\/archneur.1969.00480090076012","article-title":"Cerebrovascular \u201cmoyamoya\u201d disease. Disease showing abnormal net-like vessels in base of brain","volume":"20","author":"Suzuki","year":"1969","journal-title":"Arch Neurol"},{"key":"10.25259\/SNI_173_2024\/ref-17","doi-asserted-by":"crossref","first-page":"172","DOI":"10.1016\/S0006-8993(03)03317-1","article-title":"Upregulation of oligodendrocyte progenitor cells associated with restoration of mature oligodendrocytes and myelination in peri-infarct area in the rat brain","volume":"989","author":"Tanaka","year":"2003","journal-title":"Brain Res"},{"key":"10.25259\/SNI_173_2024\/ref-18","doi-asserted-by":"crossref","first-page":"997","DOI":"10.5551\/jat.61267","article-title":"The predictive values of different small vessel disease scores on clinical outcomes in mild ICH patients","volume":"28","author":"Xu","year":"2021","journal-title":"J Atheroscler Thromb"},{"key":"10.25259\/SNI_173_2024\/ref-19","doi-asserted-by":"crossref","first-page":"e1912","DOI":"10.1212\/WNL.0000000000207130","article-title":"Characteristics and clinical implication of white matter lesions in patients with adult moyamoya disease","volume":"100","author":"Yang","year":"2023","journal-title":"Neurology"}],"container-title":["Surgical Neurology International"],"original-title":[],"language":"en","link":[{"URL":"http:\/\/surgicalneurologyint.com\/resolution-of-white-matter-hyperintensity-after-surgical-revascularization-in-moyamoya-disease-a-report-of-three-cases\/","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"http:\/\/surgicalneurologyint.com\/surgicalint-articles\/resolution-of-white-matter-hyperintensity-after-surgical-revascularization-in-moyamoya-disease-a-report-of-three-cases\/","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2024,4,12]],"date-time":"2024-04-12T09:26:04Z","timestamp":1712913964000},"score":1,"resource":{"primary":{"URL":"http:\/\/surgicalneurologyint.com\/surgicalint-articles\/resolution-of-white-matter-hyperintensity-after-surgical-revascularization-in-moyamoya-disease-a-report-of-three-cases\/"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2024,4,12]]},"references-count":19,"alternative-id":["10.25259\/SNI_173_2024"],"URL":"https:\/\/doi.org\/10.25259\/sni_173_2024","relation":{},"ISSN":["2152-7806","2229-5097"],"issn-type":[{"value":"2152-7806","type":"electronic"},{"value":"2229-5097","type":"print"}],"subject":[],"published":{"date-parts":[[2024,4,12]]},"article-number":"131"}}