{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,15]],"date-time":"2026-07-15T01:18:54Z","timestamp":1784078334852,"version":"3.55.0"},"reference-count":33,"publisher":"Journal of Neurosurgery Publishing Group (JNSPG)","issue":"2","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JNS"],"published-print":{"date-parts":[[2017,2]]},"abstract":"<jats:sec>\n<jats:title>OBJECTIVE<\/jats:title>\n<jats:p>Quantification of the severity of vasculopathy and its impact on parenchymal hemodynamics is a necessary prerequisite for informing management decisions and evaluating intervention response in patients with moyamoya. The authors performed digital subtraction angiography and noninvasive structural and hemodynamic MRI, and they outline a new classification system for patients with moyamoya that they have named Prior Infarcts, Reactivity, and Angiography in Moyamoya Disease (PIRAMD).<\/jats:p><\/jats:sec>\n<jats:sec>\n<jats:title>METHODS<\/jats:title>\n<jats:p>Healthy control volunteers (n = 11; age 46 \u00b1 12 years [mean \u00b1 SD]) and patients (n = 25; 42 \u00b1 13.5 years) with angiographically confirmed moyamoya provided informed consent and underwent structural (T1-weighted, T2-weighted, FLAIR, MR angiography) and hemodynamic (T2*- and cerebral blood flow\u2013weighted) 3-T MRI. Cerebrovascular reactivity (CVR) in the internal carotid artery territory was assessed using susceptibility-weighted MRI during a hypercapnic stimulus. Only hemispheres without prior revascularization were assessed. Each hemisphere was considered symptomatic if localizing signs were present on neurological examination and\/or there was a history of transient ischemic attack with symptoms referable to that hemisphere. The PIRAMD factor weighting versus symptomatology was optimized using binary logistic regression and receiver operating characteristic curve analysis with bootstrapping. The PIRAMD finding was scored from 0 to 10. For each hemisphere, 1 point was assigned for prior infarct, 3 points for reduced CVR, 3 points for a modified Suzuki Score \u2265 Grade II, and 3 points for flow impairment in \u2265 2 of 7 predefined vascular territories. Hemispheres were divided into 3 severity grades based on total PIRAMD score, as follows: Grade 1, 0\u20135 points; Grade 2, 6\u20139 points; and Grade 3, 10 points.<\/jats:p><\/jats:sec>\n<jats:sec>\n<jats:title>RESULTS<\/jats:title>\n<jats:p>In 28 of 46 (60.9%) hemispheres the findings met clinical symptomatic criteria. With decreased CVR, the odds ratio of having a symptomatic hemisphere was 13 (95% CI 1.1\u201322.6, p = 0.002). The area under the curve for individual PIRAMD factors was 0.67\u20130.72, and for the PIRAMD grade it was 0.845. There were 0\/8 (0%), 10\/18 (55.6%), and 18\/20 (90%) symptomatic PIRAMD Grade 1, 2, and 3 hemispheres, respectively.<\/jats:p><\/jats:sec>\n<jats:sec>\n<jats:title>CONCLUSIONS<\/jats:title>\n<jats:p>A scoring system for total impairment is proposed that uses noninvasive MRI parameters. This scoring system correlates with symptomatology and may provide a measure of hemodynamic severity in moyamoya, which could be used for guiding management decisions and evaluating intervention response.<\/jats:p><\/jats:sec>","DOI":"10.3171\/2015.11.jns15562","type":"journal-article","created":{"date-parts":[[2016,3,11]],"date-time":"2016-03-11T14:59:32Z","timestamp":1457708372000},"page":"495-503","source":"Crossref","is-referenced-by-count":19,"title":["Prior Infarcts, Reactivity, and Angiography in Moyamoya Disease (PIRAMD): a scoring system for moyamoya severity based on multimodal hemodynamic imaging"],"prefix":"10.3171","volume":"126","author":[{"given":"Travis R.","family":"Ladner","sequence":"first","affiliation":[{"name":"Department of Radiology;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Manus J.","family":"Donahue","sequence":"additional","affiliation":[{"name":"Department of Radiology;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Daniel F.","family":"Arteaga","sequence":"additional","affiliation":[{"name":"Department of Radiology;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Carlos C.","family":"Faraco","sequence":"additional","affiliation":[{"name":"Department of Radiology;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Brent A.","family":"Roach","sequence":"additional","affiliation":[{"name":"Department of Radiology;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"L. Taylor","family":"Davis","sequence":"additional","affiliation":[{"name":"Department of Radiology;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lori C.","family":"Jordan","sequence":"additional","affiliation":[{"name":"Division of Pediatric Neurology, Department of Pediatrics; and"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Michael T.","family":"Froehler","sequence":"additional","affiliation":[{"name":"Departments of Neurology and Neurosurgery, Vanderbilt University Medical Center, Nashville, Tennessee"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Megan K.","family":"Strother","sequence":"additional","affiliation":[{"name":"Department of Radiology;"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1754","reference":[{"key":"b1-jns15562","series-title":"J Cereb Blood Flow Metab","doi-asserted-by":"publisher","first-page":"1453","DOI":"10.1038\/jcbfm.2014.106","article-title":"The vascular steal phenomenon is an incomplete contributor to negative cerebrovascular reactivity in patients with symptomatic intracranial stenosis","volume":"34","author":"Arteaga DF,","year":"2014","unstructured":"Arteaga DF, Strother MK, Faraco CC, Jordan LC, Ladner TR, Dethrage LM, : The vascular steal phenomenon is an incomplete contributor to negative cerebrovascular reactivity in patients with symptomatic intracranial stenosis. J Cereb Blood Flow Metab 34:1453\u20131462, 20142491704010.1038\/jcbfm.2014.106"},{"key":"b2-jns15562","series-title":"J Cereb Blood Flow Metab","doi-asserted-by":"publisher","first-page":"2044","DOI":"10.1038\/jcbfm.2012.105","article-title":"Visualization of altered neurovascular coupling in chronic stroke patients using multimodal functional MRI","volume":"32","author":"Blicher JU,","year":"2012","unstructured":"Blicher JU, Stagg CJ, O'Shea J, \u00d8stergaard L, MacIntosh BJ, Johansen-Berg H, : Visualization of altered neurovascular coupling in chronic stroke patients using multimodal functional MRI. J Cereb Blood Flow Metab 32:2044\u20132054, 20122282899810.1038\/jcbfm.2012.105"},{"key":"b3-jns15562","series-title":"Catheter Cardiovasc Interv","doi-asserted-by":"publisher","first-page":"175","DOI":"10.1002\/ccd.20592","article-title":"Gadolinium-based contrast agents and nephrotoxicity in patients undergoing coronary artery procedures","volume":"67","author":"Briguori C,","year":"2006","unstructured":"Briguori C, Colombo A, Airoldi F, Melzi G, Michev I, Carlino M, : Gadolinium-based contrast agents and nephrotoxicity in patients undergoing coronary artery procedures. Catheter Cardiovasc Interv 67:175\u2013180, 200610.1002\/ccd.2059216400668"},{"key":"b4-jns15562","series-title":"Stroke","doi-asserted-by":"publisher","first-page":"2810","DOI":"10.1161\/hs1201.099893","article-title":"MR perfusion imaging in moyamoya syndrome: potential implications for clinical evaluation of occlusive cerebrovascular disease","volume":"32","author":"Calamante F,","year":"2001","unstructured":"Calamante F, Ganesan V, Kirkham FJ, Jan W, Chong WK, Gadian DG, : MR perfusion imaging in moyamoya syndrome: potential implications for clinical evaluation of occlusive cerebrovascular disease. Stroke 32:2810\u20132816, 200110.1161\/hs1201.09989311739978"},{"key":"b5-jns15562","series-title":"AJNR Am J Neuroradiol","doi-asserted-by":"publisher","first-page":"1315","DOI":"10.3174\/ajnr.A2522","article-title":"Xenon-enhanced cerebral blood flow at 28% xenon provides uniquely safe access to quantitative, clinically useful cerebral blood flow information: a multi-center study","volume":"32","author":"Carlson AP,","year":"2011","unstructured":"Carlson AP, Brown AM, Zager E, Uchino K, Marks MP, Robertson C, : Xenon-enhanced cerebral blood flow at 28% xenon provides uniquely safe access to quantitative, clinically useful cerebral blood flow information: a multi-center study. AJNR Am J Neuroradiol 32:1315\u20131320, 201110.3174\/ajnr.A2522"},{"key":"b6-jns15562","series-title":"Cerebrovasc Dis","doi-asserted-by":"publisher","first-page":"41","DOI":"10.1159\/000326077","article-title":"Proposal for a new grading of Moyamoya disease in adult patients","volume":"32","author":"Czabanka M,","year":"2011","unstructured":"Czabanka M, Pe\u00f1a-Tapia P, Schubert GA, Heppner FL, Martus P, Horn P, : Proposal for a new grading of Moyamoya disease in adult patients. Cerebrovasc Dis 32:41\u201350, 201110.1159\/00032607721576942"},{"key":"b7-jns15562","series-title":"Brain","doi-asserted-by":"publisher","first-page":"595","DOI":"10.1093\/brain\/awf047","article-title":"Variability of cerebral blood volume and oxygen extraction: stages of cerebral haemodynamic impairment revisited","volume":"125","author":"Derdeyn CP,","year":"2002","unstructured":"Derdeyn CP, Videen TO, Yundt KD, Fritsch SM, Carpenter DA, Grubb RL, : Variability of cerebral blood volume and oxygen extraction: stages of cerebral haemodynamic impairment revisited. Brain 125:595\u2013607, 20021187261610.1093\/brain\/awf047"},{"key":"b8-jns15562","series-title":"J Magn Reson Imaging","doi-asserted-by":"publisher","first-page":"1129","DOI":"10.1002\/jmri.24070","article-title":"Relationships between hypercarbic reactivity, cerebral blood flow, and arterial circulation times in patients with moyamoya disease","volume":"38","author":"Donahue MJ,","year":"2013","unstructured":"Donahue MJ, Ayad M, Moore R, van Osch M, Singer R, Clemmons P, : Relationships between hypercarbic reactivity, cerebral blood flow, and arterial circulation times in patients with moyamoya disease. J Magn Reson Imaging 38:1129\u20131139, 20132344090910.1002\/jmri.24070"},{"key":"b9-jns15562","series-title":"Stroke","doi-asserted-by":"publisher","first-page":"2335","DOI":"10.1161\/STROKEAHA.114.005975","article-title":"Routine clinical evaluation of cerebrovascular reserve capacity using carbogen in patients with intracranial stenosis","volume":"45","author":"Donahue MJ,","year":"2014","unstructured":"Donahue MJ, Dethrage LM, Faraco CC, Jordan LC, Clemmons P, Singer R, : Routine clinical evaluation of cerebrovascular reserve capacity using carbogen in patients with intracranial stenosis. Stroke 45:2335\u20132341, 20142493884510.1161\/STROKEAHA.114.005975"},{"key":"b10-jns15562","series-title":"Stroke","doi-asserted-by":"publisher","first-page":"903","DOI":"10.1161\/STROKEAHA.111.635995","article-title":"Novel MRI approaches for assessing cerebral hemodynamics in ischemic cerebrovascular disease","volume":"43","author":"Donahue MJ,","year":"2012","unstructured":"Donahue MJ, Strother MK, Hendrikse J: Novel MRI approaches for assessing cerebral hemodynamics in ischemic cerebrovascular disease. Stroke 43:903\u2013915, 201210.1161\/STROKEAHA.111.63599522343644"},{"key":"b11-jns15562","series-title":"Magn Reson Med","doi-asserted-by":"publisher","first-page":"1579","DOI":"10.1002\/mrm.25268","article-title":"Dual echo vessel-encoded ASL for simultaneous BOLD and CBF reactivity assessment in patients with ischemic cerebrovascular disease","volume":"73","author":"Faraco CC,","year":"2015","unstructured":"Faraco CC, Strother MK, Dethrage LM, Jordan L, Singer R, Clemmons PF, : Dual echo vessel-encoded ASL for simultaneous BOLD and CBF reactivity assessment in patients with ischemic cerebrovascular disease. Magn Reson Med 73:1579\u20131592, 201510.1002\/mrm.2526824757044"},{"key":"b12-jns15562","series-title":"Curr Neurovasc Res","doi-asserted-by":"publisher","first-page":"49","DOI":"10.2174\/156720213804806016","article-title":"Regional cerebral blood flow and cerebrovascular reactivity in Alzheimer's disease and vascular dementia assessed by arterial spin-labeling magnetic resonance imaging","volume":"10","author":"Gao YZ,","year":"2013","unstructured":"Gao YZ, Zhang JJ, Liu H, Wu GY, Xiong L, Shu M: Regional cerebral blood flow and cerebrovascular reactivity in Alzheimer's disease and vascular dementia assessed by arterial spin-labeling magnetic resonance imaging. Curr Neurovasc Res 10:49\u201353, 201310.2174\/15672021380480601623151075"},{"key":"b13-jns15562","series-title":"Stroke","doi-asserted-by":"publisher","first-page":"2884","DOI":"10.1161\/STROKEAHA.112.663716","article-title":"Cerebrovascular reserve and stroke risk in patients with carotid stenosis or occlusion: a systematic review and meta-analysis","volume":"43","author":"Gupta A,","year":"2012","unstructured":"Gupta A, Chazen JL, Hartman M, Delgado D, Anumula N, Shao H, : Cerebrovascular reserve and stroke risk in patients with carotid stenosis or occlusion: a systematic review and meta-analysis. Stroke 43:2884\u20132891, 201210.1161\/STROKEAHA.112.66371623091119"},{"key":"b14-jns15562","series-title":"Stroke","doi-asserted-by":"publisher","first-page":"3047","DOI":"10.1161\/STROKEAHA.111.615955","article-title":"Impact of extracranial-intracranial bypass on cerebrovascular reactivity and clinical outcome in patients with symptomatic moyamoya vasculopathy","volume":"42","author":"Han JS,","year":"2011","unstructured":"Han JS, Abou-Hamden A, Mandell DM, Poublanc J, Crawley AP, Fisher JA, : Impact of extracranial-intracranial bypass on cerebrovascular reactivity and clinical outcome in patients with symptomatic moyamoya vasculopathy. Stroke 42:3047\u20133054, 201110.1161\/STROKEAHA.111.61595521903951"},{"key":"b15-jns15562","series-title":"Stroke","doi-asserted-by":"publisher","first-page":"1261","DOI":"10.1161\/STROKEAHA.110.603225","article-title":"Measurement of cerebrovascular reactivity in pediatric patients with cerebral vasculopathy using blood oxygen level\u2013dependent MRI","volume":"42","author":"Han JS,","year":"2011","unstructured":"Han JS, Mikulis DJ, Mardimae A, Kassner A, Poublanc J, Crawley AP, : Measurement of cerebrovascular reactivity in pediatric patients with cerebral vasculopathy using blood oxygen level\u2013dependent MRI. Stroke 42:1261\u20131269, 20112149390710.1161\/STROKEAHA.110.603225"},{"key":"b16-jns15562","series-title":"Brain","doi-asserted-by":"publisher","first-page":"424","DOI":"10.1093\/brain\/awg040","article-title":"Markers of endothelial dysfunction in lacunar infarction and ischaemic leukoaraiosis","volume":"126","author":"Hassan A,","year":"2003","unstructured":"Hassan A, Hunt BJ, O'Sullivan M, Parmar K, Bamford JM, Briley D, : Markers of endothelial dysfunction in lacunar infarction and ischaemic leukoaraiosis. Brain 126:424\u2013432, 200310.1093\/brain\/awg04012538408"},{"key":"b17-jns15562","series-title":"AJNR Am J Neuroradiol","doi-asserted-by":"publisher","first-page":"862","DOI":"10.3174\/ajnr.A1922","article-title":"Quantification of cerebrovascular reactivity by blood oxygen level-dependent MR imaging and correlation with conventional angiography in patients with Moyamoya disease","volume":"31","author":"Heyn C,","year":"2010","unstructured":"Heyn C, Poublanc J, Crawley A, Mandell D, Han JS, Tymianski M, : Quantification of cerebrovascular reactivity by blood oxygen level-dependent MR imaging and correlation with conventional angiography in patients with Moyamoya disease. AJNR Am J Neuroradiol 31:862\u2013867, 201010.3174\/ajnr.A192220075092"},{"key":"b18-jns15562","series-title":"Stroke","doi-asserted-by":"publisher","first-page":"1340","DOI":"10.1161\/01.STR.0000126043.83777.3a","article-title":"Regional angiographic grading system for collateral flow: correlation with cerebral infarction in patients with middle cerebral artery occlusion","volume":"35","author":"Kim JJ,","year":"2004","unstructured":"Kim JJ, Fischbein NJ, Lu Y, Pham D, Dillon WP: Regional angiographic grading system for collateral flow: correlation with cerebral infarction in patients with middle cerebral artery occlusion. Stroke 35:1340\u20131344, 20041508756410.1161\/01.STR.0000126043.83777.3a"},{"key":"b19-jns15562","series-title":"Neurosurgery","doi-asserted-by":"publisher","first-page":"752","DOI":"10.1097\/00006123-199804000-00043","article-title":"Cerebral blood flow measurement as an indicator for an indirect revascularization procedure for adult patients with moyamoya disease","volume":"42","author":"Kohno K,","year":"1998","unstructured":"Kohno K, Oka Y, Kohno S, Ohta S, Kumon Y, Sakaki S: Cerebral blood flow measurement as an indicator for an indirect revascularization procedure for adult patients with moyamoya disease. Neurosurgery 42:752\u2013758, 1998957463910.1097\/00006123-199804000-00043"},{"key":"b20-jns15562","series-title":"Stroke","doi-asserted-by":"publisher","first-page":"1430","DOI":"10.1161\/STROKEAHA.106.478297","article-title":"Radiological findings, clinical course, and outcome in asymptomatic moyamoya disease: results of multicenter survey in Japan","volume":"38","author":"Kuroda S,","year":"2007","unstructured":"Kuroda S, Hashimoto N, Yoshimoto T, Iwasaki Y: Radiological findings, clinical course, and outcome in asymptomatic moyamoya disease: results of multicenter survey in Japan. Stroke 38:1430\u20131435, 20071739586310.1161\/STROKEAHA.106.478297"},{"issue":"4","key":"b21-jns15562","series-title":"Neurosurg Focus","doi-asserted-by":"publisher","first-page":"E5","DOI":"10.3171\/2009.1.FOCUS08300","article-title":"Quantitative hemodynamic studies in moyamoya disease: a review","volume":"26","author":"Lee M,","year":"2009","unstructured":"Lee M, Zaharchuk G, Guzman R, Achrol A, Bell-Stephens T, Steinberg GK: Quantitative hemodynamic studies in moyamoya disease: a review. Neurosurg Focus 26:4E5, 20091933513110.3171\/2009.1.FOCUS08300"},{"key":"b22-jns15562","series-title":"Arch Neurol","doi-asserted-by":"publisher","first-page":"1217","DOI":"10.1001\/archneur.55.9.1217","article-title":"Lacunar infarcts defined by magnetic resonance imaging of 3660 elderly people: the Cardiovascular Health Study","volume":"55","author":"Longstreth WT Jr,","year":"1998","unstructured":"Longstreth WT Jr, Bernick C, Manolio TA, Bryan N, Jungreis CA, Price TR: Lacunar infarcts defined by magnetic resonance imaging of 3660 elderly people: the Cardiovascular Health Study. Arch Neurol 55:1217\u20131225, 199810.1001\/archneur.55.9.12179740116"},{"key":"b23-jns15562","series-title":"Neurosurg Rev","doi-asserted-by":"publisher","first-page":"347","DOI":"10.1007\/s10143-011-0312-y","article-title":"Contralateral cerebral hemodynamic changes after unilateral direct revascularization in patients with moyamoya disease","volume":"34","author":"Ma Y,","year":"2011","unstructured":"Ma Y, Li M, Jiao LQ, Zhang HQ, Ling F: Contralateral cerebral hemodynamic changes after unilateral direct revascularization in patients with moyamoya disease. Neurosurg Rev 34:347\u2013354, 201110.1007\/s10143-011-0312-y21538064"},{"key":"b24-jns15562","series-title":"AJNR Am J Neuroradiol","doi-asserted-by":"publisher","first-page":"721","DOI":"10.3174\/ajnr.A2365","article-title":"Quantitative measurement of cerebrovascular reactivity by blood oxygen level-dependent MR imaging in patients with intracranial stenosis: preoperative cerebrovascular reactivity predicts the effect of extracranialintracranial bypass surgery","volume":"32","author":"Mandell DM,","year":"2011","unstructured":"Mandell DM, Han JS, Poublanc J, Crawley AP, Fierstra J, Tymianski M, : Quantitative measurement of cerebrovascular reactivity by blood oxygen level-dependent MR imaging in patients with intracranial stenosis: preoperative cerebrovascular reactivity predicts the effect of extracranialintracranial bypass surgery. AJNR Am J Neuroradiol 32:721\u2013727, 201110.3174\/ajnr.A2365"},{"key":"b25-jns15562","series-title":"Stroke","doi-asserted-by":"publisher","first-page":"2021","DOI":"10.1161\/STROKEAHA.107.506709","article-title":"Mapping cerebrovascular reactivity using blood oxygen level-dependent MRI in Patients with arterial stenoocclusive disease: comparison with arterial spin labeling MRI","volume":"39","author":"Mandell DM,","year":"2008","unstructured":"Mandell DM, Han JS, Poublanc J, Crawley AP, Stainsby JA, Fisher JA, : Mapping cerebrovascular reactivity using blood oxygen level-dependent MRI in Patients with arterial stenoocclusive disease: comparison with arterial spin labeling MRI. Stroke 39:2021\u20132028, 200810.1161\/STROKEAHA.107.50670918451352"},{"key":"b26-jns15562","series-title":"Brain","doi-asserted-by":"publisher","first-page":"457","DOI":"10.1093\/brain\/124.3.457","article-title":"Severely impaired cerebrovascular reactivity predicts stroke and TIA risk in patients with carotid artery stenosis and occlusion","volume":"124","author":"Markus H,","year":"2001","unstructured":"Markus H, Cullinane M: Severely impaired cerebrovascular reactivity predicts stroke and TIA risk in patients with carotid artery stenosis and occlusion. Brain 124:457\u2013467, 200110.1093\/brain\/124.3.45711222446"},{"key":"b27-jns15562","series-title":"J Neurosurg","doi-asserted-by":"publisher","first-page":"347","DOI":"10.3171\/jns.2005.103.2.0347","article-title":"Preoperative and postoperative mapping of cerebrovascular reactivity in moyamoya disease by using blood oxygen level-dependent magnetic resonance imaging","volume":"103","author":"Mikulis DJ,","year":"2005","unstructured":"Mikulis DJ, Krolczyk G, Desal H, Logan W, Deveber G, Dirks P, : Preoperative and postoperative mapping of cerebrovascular reactivity in moyamoya disease by using blood oxygen level-dependent magnetic resonance imaging. J Neurosurg 103:347\u2013355, 200510.3171\/jns.2005.103.2.034716175867"},{"key":"b28-jns15562","series-title":"AJNR Am J Neuroradiol","first-page":"1534","article-title":"Use of the Alberta Stroke Program Early CT Score (ASPECTS) for assessing CT scans in patients with acute stroke","volume":"22","author":"Pexman JHW,","year":"2001","unstructured":"Pexman JHW, Barber PA, Hill MD, Sevick RJ, Demchuk AM, Hudon ME, : Use of the Alberta Stroke Program Early CT Score (ASPECTS) for assessing CT scans in patients with acute stroke. AJNR Am J Neuroradiol 22:1534\u20131542, 200111559501"},{"key":"b29-jns15562","series-title":"Neuroimage","doi-asserted-by":"publisher","first-page":"276","DOI":"10.1016\/j.neuroimage.2014.09.033","article-title":"Neuronal activation induced BOLD and CBF responses upon acetazolamide administration in patients with stenoocclusive artery disease","volume":"105","author":"Siero JCW,","year":"2015","unstructured":"Siero JCW, Hartkamp NS, Donahue MJ, Harteveld AA, Compter A, Petersen ET, : Neuronal activation induced BOLD and CBF responses upon acetazolamide administration in patients with stenoocclusive artery disease. Neuroimage 105:276\u2013285, 201510.1016\/j.neuroimage.2014.09.033"},{"key":"b30-jns15562","series-title":"AJNR Am J Neuroradiol","doi-asserted-by":"publisher","first-page":"1318","DOI":"10.3174\/ajnr.A3883","article-title":"Cerebrovascular collaterals correlate with disease severity in adult North American patients with Moyamoya disease","volume":"35","author":"Strother MK,","year":"2014","unstructured":"Strother MK, Anderson MD, Singer RJ, Du L, Moore RD, Shyr Y, : Cerebrovascular collaterals correlate with disease severity in adult North American patients with Moyamoya disease. AJNR Am J Neuroradiol 35:1318\u20131324, 20142465181410.3174\/ajnr.A3883"},{"key":"b31-jns15562","series-title":"AJNR Am J Neuroradiol","doi-asserted-by":"publisher","first-page":"277","DOI":"10.3174\/ajnr.A3211","article-title":"Patient radiation dose management in the followup of potential skin injuries in neuroradiology","volume":"34","author":"Vano E,","year":"2013","unstructured":"Vano E, Fernandez JM, Sanchez RM, Martinez D, Ibor LL, Gil A, : Patient radiation dose management in the followup of potential skin injuries in neuroradiology. AJNR Am J Neuroradiol 34:277\u2013282, 201310.3174\/ajnr.A3211"},{"key":"b32-jns15562","series-title":"JAMA","doi-asserted-by":"publisher","first-page":"1421","DOI":"10.1001\/jama.1995.03520420037035","article-title":"Endarterectomy for asymptomatic carotid artery stenosis. Executive Committee for the Asymptomatic Carotid Atherosclerosis Study","volume":"273","author":"Walker MD,","year":"1995","unstructured":"Walker MD, Marler JR, Goldstein M, Grady P, Toole J, Baker W: Endarterectomy for asymptomatic carotid artery stenosis. Executive Committee for the Asymptomatic Carotid Atherosclerosis Study. JAMA 273:1421\u20131428, 199510.1001\/jama.1995.03520420037035"},{"key":"b33-jns15562","series-title":"Stroke","doi-asserted-by":"publisher","first-page":"2485","DOI":"10.1161\/STROKEAHA.111.616466","article-title":"Arterial spin-labeling MRI can identify the presence and intensity of collateral perfusion in patients with moyamoya disease","volume":"42","author":"Zaharchuk G,","year":"2011","unstructured":"Zaharchuk G, Do HM, Marks MP, Rosenberg J, Moseley ME, Steinberg GK: Arterial spin-labeling MRI can identify the presence and intensity of collateral perfusion in patients with moyamoya disease. Stroke 42:2485\u20132491, 201110.1161\/STROKEAHA.111.61646621799169"}],"container-title":["Journal of Neurosurgery"],"original-title":[],"link":[{"URL":"https:\/\/thejns.org\/view\/journals\/j-neurosurg\/126\/2\/article-p495.xml","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/thejns.org\/downloadpdf\/journals\/j-neurosurg\/126\/2\/article-p495.xml","content-type":"text\/html","content-version":"vor","intended-application":"syndication"},{"URL":"https:\/\/thejns.org\/downloadpdf\/journals\/j-neurosurg\/126\/2\/article-p495.xml","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,3,23]],"date-time":"2025-03-23T03:05:26Z","timestamp":1742699126000},"score":1,"resource":{"primary":{"URL":"https:\/\/thejns.org\/view\/journals\/j-neurosurg\/126\/2\/article-p495.xml"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2017,2]]},"references-count":33,"journal-issue":{"issue":"2"},"URL":"https:\/\/doi.org\/10.3171\/2015.11.jns15562","relation":{},"ISSN":["0022-3085","1933-0693"],"issn-type":[{"value":"0022-3085","type":"print"},{"value":"1933-0693","type":"electronic"}],"subject":[],"published":{"date-parts":[[2017,2]]}}}