{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,11]],"date-time":"2026-07-11T13:31:46Z","timestamp":1783776706785,"version":"3.55.0"},"reference-count":24,"publisher":"Journal of Neurosurgery Publishing Group (JNSPG)","issue":"5","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["PED"],"published-print":{"date-parts":[[2012,11]]},"abstract":"<jats:sec>\n<jats:title>Object<\/jats:title>\n<jats:p>Surgical revascularization is considered an effective treatment for juvenile patients with moyamoya disease (MMD). Yet the long-term outcome in surgically treated patients still needs to be clarified. More than 30 years have passed since the authors' department started intensively treating pediatric patients with MMD using indirect anastomosis techniques. In this study the authors surveyed the current status of these patients.<\/jats:p><\/jats:sec>\n<jats:sec>\n<jats:title>Methods<\/jats:title>\n<jats:p>Activities of daily living (ADLs) were surveyed and present clinical status was assessed based on the modified Rankin Scale (mRS). Cerebrovascular events subsequent to surgical treatment were also recorded.<\/jats:p><\/jats:sec>\n<jats:sec>\n<jats:title>Results<\/jats:title>\n<jats:p>Since 1979, 208 patients younger than 19 years of age with MMD were surgically treated and followed up for &gt; 3 years. Data were available on 172 patients (83%), who had been followed up for a mean of 14.3 years (range 3\u201332 years). Activity of daily living outcomes were as follows: 138 patients (80.2%) had mRS scores of 0\u20132, 29 (16.9%) a score of 3, 1 (0.6%) a score of 4, 1 (0.6%) a score of 5, and 3 (1.7%) a score of 6. Cerebrovascular events occurred 8 or more years after surgery in 6 patients (3.4%), that is, 6 hemorrhages and 3 infarctions. The cumulative risk of late-onset stroke at 10, 20, and 30 years after surgical intervention was 0.8%, 6.3%, and 10.0%, respectively.<\/jats:p><\/jats:sec>\n<jats:sec>\n<jats:title>Conclusions<\/jats:title>\n<jats:p>This long-term survey demonstrated that most surgically treated pediatric patients with MMD maintain good ADL outcomes. However, a significant number of new cerebrovascular events occurred more than 10 years after the initial surgery. Additional follow-up will help to identify which events may occur during the adult years of patients treated as children.<\/jats:p><\/jats:sec>","DOI":"10.3171\/2012.8.peds11539","type":"journal-article","created":{"date-parts":[[2012,9,7]],"date-time":"2012-09-07T13:57:24Z","timestamp":1347026244000},"page":"451-456","source":"Crossref","is-referenced-by-count":41,"title":["Long-term follow-up of surgically treated juvenile patients with moyamoya disease"],"prefix":"10.3171","volume":"10","author":[{"given":"Maki","family":"Mukawa","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tadashi","family":"Nariai","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yoshiharu","family":"Matsushima","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yoji","family":"Tanaka","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Motoki","family":"Inaji","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Taketoshi","family":"Maehara","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Masaru","family":"Aoyagi","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kikuo","family":"Ohno","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1754","reference":[{"key":"b1-peds11539","series-title":"J Clin Neurosci","doi-asserted-by":"publisher","first-page":"873","DOI":"10.1016\/j.jocn.2004.11.008","article-title":"Long term outcome in children with Moyamoya disease: experience with 16 patients","volume":"12","author":"Darwish","year":"2005"},{"key":"b2-peds11539","series-title":"Surg Neurol","doi-asserted-by":"publisher","first-page":"138","DOI":"10.1016\/S0090-3019(96)00358-8","article-title":"Current state of study on moyamoya disease in Japan","volume":"47","author":"Fukui","year":"1997"},{"key":"b3-peds11539","series-title":"Brain Dev","doi-asserted-by":"publisher","first-page":"21","DOI":"10.1016\/S0387-7604(85)80055-3","article-title":"Clinical and cerebral angiographic evolutions of idiopathic progressive occlusive disease of the circle of Willis (\u201cmoyamoya\u201d disease) in children","volume":"7","author":"Fukuyama","year":"1985"},{"key":"b4-peds11539","series-title":"Neurol Med Chir (Tokyo)","doi-asserted-by":"publisher","first-page":"783","DOI":"10.2176\/nmc.36.783","article-title":"Angiographic analysis of moyamoya disease\u2014how does moyamoya disease progress?","volume":"36","author":"Houkin","year":"1996"},{"key":"b5-peds11539","series-title":"Neuropediatrics","doi-asserted-by":"publisher","first-page":"294","DOI":"10.1055\/s-2007-973508","article-title":"Serial intelligence test scores in pediatric moyamoya disease","volume":"30","author":"Imaizumi","year":"1999"},{"key":"b6-peds11539","series-title":"Pediatr Neurosurg","doi-asserted-by":"publisher","first-page":"14","DOI":"10.1159\/000048343","article-title":"Long-term outcomes of pediatric moyamoya disease treated by encephalo-duro-arterio-synangiosis","volume":"36","author":"Isono","year":"2002"},{"key":"b7-peds11539","series-title":"J Neurosurg","doi-asserted-by":"publisher","first-page":"679","DOI":"10.3171\/jns.1978.49.5.0679","article-title":"Treatment of moyamoya disease with STA-MCA anastomosis","volume":"49","author":"Karasawa","year":"1978"},{"key":"b8-peds11539","series-title":"Neurol Med Chir (Tokyo)","first-page":"29","article-title":"A surgical treatment of \u201cmoyamoya\u201d disease \u201cencephalo-myo synangiosis","volume":"17","author":"Karasawa","year":"1977"},{"key":"b9-peds11539","series-title":"Childs Nerv Syst","doi-asserted-by":"publisher","first-page":"316","DOI":"10.1007\/s00381-003-0742-0","article-title":"Encephaloduroarteriosynangiosis with bifrontal encephalogaleo(periosteal)synangiosis in the pediatric moyamoya disease: the surgical technique and its outcomes","volume":"19","author":"Kim","year":"2003"},{"key":"b10-peds11539","series-title":"Surg Neurol","first-page":"353","article-title":"The Moyamoya syndrome and the neurosurgeon","volume":"4","author":"Krayenb\u00fchl","year":"1975"},{"key":"b11-peds11539","series-title":"Neurosurgery","doi-asserted-by":"publisher","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"},{"key":"b12-peds11539","series-title":"Pediatr Neurol","doi-asserted-by":"publisher","first-page":"274","DOI":"10.1016\/0887-8994(85)90027-X","article-title":"Prognosis of occlusive disease of the circle of Willis (moyamoya disease) in children","volume":"1","author":"Kurokawa","year":"1985"},{"key":"b13-peds11539","series-title":"Surg Neurol","doi-asserted-by":"publisher","first-page":"313","DOI":"10.1016\/S0090-3019(81)80017-1","article-title":"A new surgical treatment of moyamoya disease in children: a preliminary report","volume":"15","author":"Matsushima","year":"1981"},{"key":"b14-peds11539","series-title":"Childs Brain","first-page":"155","article-title":"Moyamoya disease in children and its surgical treatment. Introduction of a new surgical procedure and its follow-up angiograms","volume":"11","author":"Matsushima","year":"1984"},{"issue":"5","key":"b15-peds11539","series-title":"Neurosurg Focus","first-page":"e5","article-title":"Long-term outcome after STA-MCA anastomosis for moyamoya disease","volume":"5","author":"Miyamoto","year":"1998"},{"key":"b16-peds11539","series-title":"J Neurol Neurosurg Psychiatry","doi-asserted-by":"publisher","first-page":"663","DOI":"10.1136\/jnnp.2003.025049","article-title":"Severe haemodynamic stress in selected subtypes of patients with moyamoya disease: a positron emission tomography study","volume":"76","author":"Nariai","year":"2005"},{"key":"b17-peds11539","series-title":"AJNR Am J Neuroradiol","first-page":"563","article-title":"Vascular reserve in chronic cerebral ischemia measured by the acetazolamide challenge test: comparison with positron emission tomography","volume":"16","author":"Nariai","year":"1995"},{"key":"b18-peds11539","series-title":"Stroke","doi-asserted-by":"publisher","first-page":"1014","DOI":"10.1161\/01.STR.25.5.1014","article-title":"Surgically induced angiogenesis to compensate for hemodynamic cerebral ischemia","volume":"25","author":"Nariai","year":"1994"},{"key":"b19-peds11539","series-title":"Pediatr Neurol","doi-asserted-by":"publisher","first-page":"199","DOI":"10.1016\/0887-8994(94)90023-X","article-title":"Encephaloduroarteriosynangiosis (EDAS) for the treatment of childhood moyamoya disease","volume":"10","author":"Ross","year":"1994"},{"issue":"2 Suppl Pediatrics","key":"b20-peds11539","series-title":"J Neurosurg","first-page":"142","article-title":"Long-term outcome in children with moyamoya syndrome after cranial revascularization by pial synangiosis","volume":"100","author":"Scott","year":"2004"},{"key":"b21-peds11539","series-title":"Arch Neurol","doi-asserted-by":"publisher","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"},{"key":"b22-peds11539","series-title":"Childs Brain","first-page":"1","article-title":"Treatment of moyamoya disease by temporal muscle graft \u2018encephalo-myo-synangiosis\u2019","volume":"10","author":"Takeuchi","year":"1983"},{"key":"b23-peds11539","series-title":"J Cereb Blood Flow Metab","doi-asserted-by":"publisher","first-page":"291","DOI":"10.1038\/sj.jcbfm.9600187","article-title":"Quantitative evaluation of cerebral hemodynamics in patients with moyamoya disease by dynamic susceptibility contrast magnetic resonance imaging\u2014comparison with positron emission tomography","volume":"26","author":"Tanaka","year":"2006"},{"key":"b24-peds11539","series-title":"Stroke","doi-asserted-by":"publisher","first-page":"604","DOI":"10.1161\/01.STR.19.5.604","article-title":"Interobserver agreement for the assessment of handicap in stroke patients","volume":"19","author":"van Swieten","year":"1988"}],"container-title":["Journal of Neurosurgery: Pediatrics"],"original-title":[],"link":[{"URL":"https:\/\/thejns.org\/view\/journals\/j-neurosurg-pediatr\/10\/5\/article-p451.xml","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/thejns.org\/downloadpdf\/journals\/j-neurosurg-pediatr\/10\/5\/article-p451.xml","content-type":"text\/html","content-version":"vor","intended-application":"syndication"},{"URL":"https:\/\/thejns.org\/downloadpdf\/journals\/j-neurosurg-pediatr\/10\/5\/article-p451.xml","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,4,15]],"date-time":"2023-04-15T14:33:15Z","timestamp":1681569195000},"score":1,"resource":{"primary":{"URL":"https:\/\/thejns.org\/view\/journals\/j-neurosurg-pediatr\/10\/5\/article-p451.xml"}},"subtitle":["Clinical article"],"short-title":[],"issued":{"date-parts":[[2012,11]]},"references-count":24,"journal-issue":{"issue":"5"},"URL":"https:\/\/doi.org\/10.3171\/2012.8.peds11539","relation":{},"ISSN":["1933-0707","1933-0715"],"issn-type":[{"value":"1933-0707","type":"print"},{"value":"1933-0715","type":"electronic"}],"subject":[],"published":{"date-parts":[[2012,11]]}}}