{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,15]],"date-time":"2026-07-15T10:55:58Z","timestamp":1784112958443,"version":"3.55.0"},"reference-count":86,"publisher":"Journal of Neurosurgery Publishing Group (JNSPG)","issue":"4","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["FOC"],"published-print":{"date-parts":[[2009,4]]},"abstract":"<jats:p>Moyamoya disease is a chronic cerebrovascular occlusive disorder that results in severe morbidity and death. There is much controversy surrounding the optimal treatment for adult patients with the disorder. There have been no randomized trials to assess the efficacy of any single surgical treatment, and existing case series suffer from inadequate power, selection bias, and inherent differences in patient characteristics. In this article the authors review the literature concerning the optimal surgical treatment of adult patients with moyamoya disease.<\/jats:p>","DOI":"10.3171\/2009.01.focus08309","type":"journal-article","created":{"date-parts":[[2009,3,31]],"date-time":"2009-03-31T12:12:42Z","timestamp":1238501562000},"page":"E8","source":"Crossref","is-referenced-by-count":58,"title":["Optimal surgical treatment for moyamoya disease in adults: direct versus indirect bypass"],"prefix":"10.3171","volume":"26","author":[{"given":"Robert M.","family":"Starke","sequence":"first","affiliation":[{"name":"Department of Neurosurgery, Columbia University, New York"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ricardo J.","family":"Komotar","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Columbia University, New York"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"E. Sander","family":"Connolly","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Columbia University, New York"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1754","reference":[{"key":"b1-0260008","series-title":"Pediatr Neurosurg","first-page":"26","article-title":"Pial synangiosis for moyamoya syndrome in children","volume":"23","author":"Adelson","year":"1995"},{"key":"b2-0260008","series-title":"Stroke","first-page":"826","article-title":"Cerebral infarction due to moyamoya disease in young adults","volume":"19","author":"Bruno","year":"1988"},{"key":"b3-0260008","series-title":"Stroke","first-page":"53","article-title":"Moyamoya disease in Taiwan","volume":"19","author":"Chen","year":"1988"},{"key":"b4-0260008","series-title":"Stroke","first-page":"1347","article-title":"Clinical features of moyamoya disease in the United States","volume":"29","author":"Chiu","year":"1998"},{"key":"b5-0260008","series-title":"Surg Neurol","article-title":"Incidence and risk factors for symptomatic cerebral hyperperfusion after superficial temporal artery-middle cerebral artery anastomosis in patients with moyamoya disease","author":"Fujimura","year":"2008"},{"issue":"2 Suppl","key":"b6-0260008","series-title":"Clin Neurol Neurosurg","first-page":"S238","article-title":"Guidelines for the diagnosis and treatment of spontaneous occlusion of the circle of Willis (\u2018moyamoya\u2019 disease). 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Can surgical revascularization prevent the recurrence of intracerebral hemorrhage?","volume":"27","author":"Houkin","year":"1996"},{"key":"b11-0260008","series-title":"Stroke","first-page":"1170","article-title":"Effects of surgical revascularization on outcome of patients with pediatric moyamoya disease","volume":"28","author":"Ishikawa","year":"1997"},{"key":"b12-0260008","series-title":"Neurol Med Chir (Tokyo)","first-page":"29","article-title":"A surgical treatment of \u201cmoyamoya\u201d disease \u201cencephalo-myo synangiosis.\u201d","volume":"17","author":"Karasawa","year":"1977"},{"key":"b13-0260008","series-title":"J Neurosurg","first-page":"84","article-title":"Long-term follow-up study after extracranial-intracranial bypass surgery for anterior circulation ischemia in childhood moyamoya disease","volume":"77","author":"Karasawa","year":"1992"},{"key":"b14-0260008","series-title":"Neurosurgery","first-page":"1048","article-title":"Effect of moyamoya disease on 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Research Committee on Spontaneous Occlusion of the Circle of Willis (Moyamoya Disease) of the Ministry of Health and Welfare, Japan","volume":"99","author":"Fukui","year":"1997"},{"key":"b7-0260008","series-title":"Stroke","first-page":"1490","article-title":"Clinical features and outcome in North American adults with moyamoya phenomenon","volume":"37","author":"Hallemeier","year":"2006"},{"issue":"2 Suppl","key":"b8-0260008","series-title":"Clin Neurol Neurosurg","first-page":"S151","article-title":"Moyamoya disease in adults: characteristics of clinical presentation and outcome after encephalo-duro-arterio-synangiosis","volume":"99","author":"Han","year":"1997"},{"issue":"2 Suppl","key":"b9-0260008","series-title":"Clin Neurol Neurosurg","first-page":"S142","article-title":"Direct and indirect revascularization for moyamoya disease surgical techniques and peri-operative complications","volume":"99","author":"Houkin","year":"1997"},{"key":"b10-0260008","series-title":"Stroke","first-page":"1342","article-title":"Surgical therapy for adult moyamoya disease. 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disease","volume":"66","author":"Kim","year":"2006"},{"key":"b18-0260008","series-title":"Cerebrovasc Dis","first-page":"580","article-title":"Transient hyperperfusion after superficial temporal artery\/middle cerebral artery bypass surgery as a possible cause of postoperative transient neurological deterioration","volume":"25","author":"Kim","year":"2008"},{"key":"b19-0260008","series-title":"Neurosurgery","first-page":"527","article-title":"Surgical treatment of moyamoya disease: operative technique for encephalo-duro-arterio-myo-synangiosis, its follow-up, clinical results, and angiograms","volume":"32","author":"Kinugasa","year":"1993"},{"key":"b20-0260008","series-title":"Surg Neurol","first-page":"455","article-title":"Ribbon enchephalo-duro-arterio-myo-synangiosis for moyamoya disease","volume":"41","author":"Kinugasa","year":"1994"},{"key":"b21-0260008","series-title":"Stroke","first-page":"3193","article-title":"Moyamoya disease in 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