{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,18]],"date-time":"2026-08-18T04:02:07Z","timestamp":1787025727552,"version":"build-2736575974"},"reference-count":32,"publisher":"Journal of Neurosurgery Publishing Group (JNSPG)","issue":"6","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["PED"],"published-print":{"date-parts":[[2010,12]]},"abstract":"<jats:p>Moyamoya disease is a rare cerebrovascular disease characterized by idiopathic bilateral stenosis or occlusion of bilateral internal carotid arteries and the development of characteristic leptomeningeal collateral vessels at the base of the brain. Typical presentations include transient ischemic attacks or stroke, and hemorrhage. Presentation with movement disorders is extremely rare, especially in the pediatric population. The authors describe the cases of 4 children with moyamoya disease who presented with movement disorders.<\/jats:p>\n                  <jats:p>Among 446 patients (118 pediatric) with moyamoya disease surgically treated by the senior author, 4 pediatric patients had presented with movement disorders. The clinical records, imaging studies, surgical details, and postoperative clinical and imaging data were retrospectively reviewed.<\/jats:p>\n                  <jats:p>The initial presenting symptom was movement disorder in all 4 patients: chorea in 2, hemiballismus in 1, and involuntary limb shaking in 1. All the patients had watershed infarcts involving the frontal subcortical region on MR imaging. Additionally, 1 patient had a ganglionic infarct. Single-photon emission computed tomography studies showed frontoparietal cortical and subcortical hypoperfusion in all patients. Three patients had bilateral disease, whereas 1 had unilateral disease. All the patients underwent superficial temporal artery\u2013middle cerebral artery bypass. Postoperatively, all 4 patients had complete improvement in their symptoms. The SPECT scans revealed normal perfusion in 3 patients and a small residual perfusion deficit in 1.<\/jats:p>\n                  <jats:p>Movement disorders are a rare presenting feature of moyamoya disease. Hypoperfusion of the frontal cortical and subcortical region was seen in all patients, and the symptomatology was attributed to ischemic dysfunction and imbalance in the cortical-subcortical-ganglionic-thalamic-cortical circuitry. Combined revascularization with superficial temporal artery\u2013middle cerebral artery bypass and encephaloduroarteriosynangiosis leads to excellent results.<\/jats:p>","DOI":"10.3171\/2010.9.peds10192","type":"journal-article","created":{"date-parts":[[2010,12,1]],"date-time":"2010-12-01T10:00:47Z","timestamp":1291197647000},"page":"559-566","source":"Crossref","is-referenced-by-count":43,"title":["Patients with moyamoya disease presenting with movement disorder"],"prefix":"10.3171","volume":"6","author":[{"given":"Paritosh","family":"Pandey","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Teresa","family":"Bell-Stephens","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gary K.","family":"Steinberg","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1754","reference":[{"key":"b1-0060559","series-title":"Mov Disord","doi-asserted-by":"publisher","first-page":"1482","DOI":"10.1002\/mds.23130","article-title":"Movement disorders associated with moyamoya disease: a report of 4 new cases and a review of literatures","volume":"25","author":"Baik","year":"2010"},{"key":"b2-0060559","series-title":"Pediatr Neurol","doi-asserted-by":"publisher","first-page":"157","DOI":"10.1016\/S0887-8994(01)00367-8","article-title":"Moyamoya, dystonia during hyperventilation, and antiphospholipid antibodies","volume":"26","author":"Bakdash","year":"2002"},{"key":"b3-0060559","series-title":"J Neurol","doi-asserted-by":"publisher","first-page":"371","DOI":"10.1007\/BF00314386","article-title":"Acute hemichorea due to infarction in the corona radiata","volume":"236","author":"Barinagarrementeria","year":"1989"},{"key":"b4-0060559","series-title":"Stroke","doi-asserted-by":"publisher","first-page":"1347","DOI":"10.1161\/01.STR.29.7.1347","article-title":"Clinical features of moyamoya disease in the United States","volume":"29","author":"Chiu","year":"1998"},{"key":"b5-0060559","series-title":"Principles of Neural Science","first-page":"853","article-title":"The basal ganglia","author":"DeLong","year":"2000"},{"issue":"Suppl 2","key":"b6-0060559","series-title":"Clin Neurol Neurosurg","doi-asserted-by":"publisher","first-page":"S238","DOI":"10.1016\/S0303-8467(97)00082-6","article-title":"Guidelines for the diagnosis and treatment of spontaneous occlusion of the circle of Willis (\u2018moyamoya\u2019 disease). 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