{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,26]],"date-time":"2026-09-26T10:13:25Z","timestamp":1790417605077,"version":"4.1.0"},"reference-count":34,"publisher":"Journal of Neurosurgery Publishing Group (JNSPG)","issue":"5","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2018,5]]},"abstract":"<jats:sec><jats:title>OBJECTIVE<\/jats:title><jats:p>Bypass surgery is the most common treatment for moyamoya disease (MMD), but there is controversy over which surgical modality is best. The objective of this study was to evaluate the clinical outcome of patients with MMD after undergoing different surgical modalities.<\/jats:p><\/jats:sec><jats:sec><jats:title>METHODS<\/jats:title><jats:p>A series of 696 consecutive MMD patients treated between June 2009 and May 2015 were screened in this prospective cohort study. Patients who did not undergo revascularization surgeries and those who underwent different surgical modalities in bilateral hemispheres were excluded. Finally, 529 patients who were observed for at least 12 months were included: 438 patients underwent unilateral surgery, and 91 patients underwent bilateral surgery. Of these, 241 patients underwent direct bypass (DB); 81, a combined bypass (CB); and 207, an indirect bypass (IB). Three clinical outcomes were evaluated and compared between surgical groups: recurrent stroke events, modified Rankin Scale (mRS) scores, and change in the main symptoms.<\/jats:p><\/jats:sec><jats:sec><jats:title>RESULTS<\/jats:title><jats:p>The mean follow-up period was 40 months. During the follow-up period, recurrent stroke was observed in 43 patients, including 15 patients with hemorrhage, 26 patients with ischemia (transient ischemic attack in 19 patients and infarction in 7 patients), and 2 patients with both hemorrhage and cerebral infarction. Kaplan-Meier analysis showed that patients who underwent a CB or DB had a longer ischemia-free time than those who underwent IB (p = 0.013); however, there was no significant difference in the hemorrhage-free time between the different surgical modalities (p = 0.534). A good neurological status (mRS score \u2264 2) was achieved in 495 patients (93.6%) and was significantly achieved by more children (98.2%) than adults (92.3%; p = 0.022). Surgical modalities were not significantly associated with outcome neurological status (p = 0.860). Moreover, improvement in symptoms was observed in 449 patients (84.9%) and was also significantly more common in children (93.0%) than in adults (82.7%; p = 0.006). No significant difference was observed between the different surgical modalities (p = 0.548).<\/jats:p><\/jats:sec><jats:sec><jats:title>CONCLUSIONS<\/jats:title><jats:p>CB and DB are more effective at preventing recurrent ischemic strokes than IB. However, there is no evidence that these 3 surgical modalities demonstrate significant differences in preventing recurrent hemorrhage.<\/jats:p><\/jats:sec>","DOI":"10.3171\/2016.12.jns162626","type":"journal-article","created":{"date-parts":[[2017,7,7]],"date-time":"2017-07-07T13:59:10Z","timestamp":1499435950000},"page":"1327-1337","source":"Crossref","is-referenced-by-count":59,"title":["Effects of different surgical modalities on the clinical outcome of patients with moyamoya disease: a prospective cohort study"],"prefix":"10.3171","volume":"128","author":[{"given":"Xiaofeng","family":"Deng","sequence":"first","affiliation":[{"name":"Departments of Neurosurgery and"},{"name":"Beijing Key Laboratory of Translational Medicine for Cerebrovascular Disease, Beijing, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Faliang","family":"Gao","sequence":"additional","affiliation":[{"name":"Departments of Neurosurgery and"},{"name":"Beijing Key Laboratory of Translational Medicine for Cerebrovascular Disease, Beijing, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Dong","family":"Zhang","sequence":"additional","affiliation":[{"name":"Departments of Neurosurgery and"},{"name":"Beijing Key Laboratory of Translational Medicine for Cerebrovascular Disease, Beijing, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yan","family":"Zhang","sequence":"additional","affiliation":[{"name":"Departments of Neurosurgery and"},{"name":"Beijing Key Laboratory of Translational Medicine for Cerebrovascular Disease, Beijing, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rong","family":"Wang","sequence":"additional","affiliation":[{"name":"Departments of Neurosurgery and"},{"name":"Beijing Key Laboratory of Translational Medicine for Cerebrovascular Disease, Beijing, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shuo","family":"Wang","sequence":"additional","affiliation":[{"name":"Departments of Neurosurgery and"},{"name":"Beijing Key Laboratory of Translational Medicine for Cerebrovascular Disease, Beijing, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yong","family":"Cao","sequence":"additional","affiliation":[{"name":"Departments of Neurosurgery and"},{"name":"Beijing Key Laboratory of Translational Medicine for Cerebrovascular Disease, Beijing, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yuanli","family":"Zhao","sequence":"additional","affiliation":[{"name":"Departments of Neurosurgery and"},{"name":"Beijing Key Laboratory of Translational Medicine for Cerebrovascular Disease, Beijing, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yuesong","family":"Pan","sequence":"additional","affiliation":[{"name":"China National Clinical Research Center for Neurological Diseases;"},{"name":"Neurology, Beijing Tiantan Hospital, Capital Medical University;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xun","family":"Ye","sequence":"additional","affiliation":[{"name":"Departments of Neurosurgery and"},{"name":"Beijing Key Laboratory of Translational Medicine for Cerebrovascular Disease, Beijing, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xingju","family":"Liu","sequence":"additional","affiliation":[{"name":"Departments of Neurosurgery and"},{"name":"Beijing Key Laboratory of Translational Medicine for Cerebrovascular Disease, Beijing, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Qian","family":"Zhang","sequence":"additional","affiliation":[{"name":"Departments of Neurosurgery and"},{"name":"Beijing Key Laboratory of Translational Medicine for Cerebrovascular Disease, Beijing, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jia","family":"Wang","sequence":"additional","affiliation":[{"name":"Departments of Neurosurgery and"},{"name":"Beijing Key Laboratory of Translational Medicine for Cerebrovascular Disease, Beijing, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ziwen","family":"Yang","sequence":"additional","affiliation":[{"name":"Departments of Neurosurgery and"},{"name":"Beijing Key Laboratory of Translational Medicine for Cerebrovascular Disease, Beijing, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Meng","family":"Zhao","sequence":"additional","affiliation":[{"name":"Departments of Neurosurgery and"},{"name":"Beijing Key Laboratory of Translational Medicine for Cerebrovascular Disease, Beijing, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jizong","family":"Zhao","sequence":"additional","affiliation":[{"name":"Departments of Neurosurgery and"},{"name":"Beijing Key Laboratory of Translational Medicine for Cerebrovascular Disease, Beijing, China"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1754","reference":[{"key":"b1","series-title":"J Neurosurg","doi-asserted-by":"publisher","first-page":"1394","DOI":"10.3171\/2014.8.JNS132176","article-title":"Surgical outcomes following encephaloduroarteriosynangiosis in North American adults with moyamoya","volume":"121","author":"Agarwalla PK","year":"2014","unstructured":"Agarwalla PK, Stapleton CJ, Phillips MT, Walcott BP, Venteicher AS, Ogilvy CS: Surgical outcomes following encephaloduroarteriosynangiosis in North American adults with moyamoya. J Neurosurg 121:1394\u20131400, 20142528009410.3171\/2014.8.JNS132176"},{"key":"b2","series-title":"Childs Nerv Syst","doi-asserted-by":"publisher","first-page":"237","DOI":"10.1007\/s00381-011-1535-5","article-title":"Hemorrhagic moyamoya disease in children: clinical features and surgical outcome","volume":"28","author":"Ahn JH","year":"2012","unstructured":"Ahn JH, Wang KC, Phi JH, Lee JY, Cho BK, Kim IO, : Hemorrhagic moyamoya disease in children: clinical features and surgical outcome. Childs Nerv Syst 28:237\u2013245, 20122180535810.1007\/s00381-011-1535-5"},{"issue":"Suppl 1","key":"b3","series-title":"Neurosurgery","doi-asserted-by":"publisher","first-page":"S116","DOI":"10.1227\/NEU.0000000000000229","article-title":"Advances and surgical considerations in the treatment of moyamoya disease","volume":"74","author":"Arias EJ","year":"2014","unstructured":"Arias EJ, Derdeyn CP, Dacey RG Jr, Zipfel GJ: Advances and surgical considerations in the treatment of moyamoya disease. Neurosurgery 74 (Suppl 1):S116\u2013S125, 20142440248010.1227\/NEU.0000000000000229"},{"key":"b4","series-title":"J Neurol Neurosurg Psychiatry","doi-asserted-by":"publisher","first-page":"900","DOI":"10.1136\/jnnp.2007.130666","article-title":"Novel epidemiological features of moyamoya disease","volume":"79","author":"Baba T","year":"2008","unstructured":"Baba T, Houkin K, Kuroda S: Novel epidemiological features of moyamoya disease. J Neurol Neurosurg Psychiatry 79:900\u2013904, 20081807747910.1136\/jnnp.2007.130666"},{"key":"b5","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 D","year":"1998","unstructured":"Chiu D, Shedden P, Bratina P, Grotta JC: Clinical features of moyamoya disease in the United States. Stroke 29:1347\u20131351, 199810.1161\/01.STR.29.7.13479660385"},{"key":"b6","series-title":"Stroke","doi-asserted-by":"publisher","first-page":"3025","DOI":"10.1161\/STROKEAHA.114.005624","article-title":"Long-term outcomes after combined revascularization surgery in adult moyamoya disease","volume":"45","author":"Cho WS","year":"2014","unstructured":"Cho WS, Kim JE, Kim CH, Ban SP, Kang HS, Son YJ, : Long-term outcomes after combined revascularization surgery in adult moyamoya disease. Stroke 45:3025\u20133031, 20142518435910.1161\/STROKEAHA.114.005624"},{"key":"b7","series-title":"Stroke","doi-asserted-by":"publisher","first-page":"56","DOI":"10.1161\/STROKEAHA.111.621300","article-title":"Moyamoya disease in China: its clinical features and outcomes","volume":"43","author":"Duan L","year":"2012","unstructured":"Duan L, Bao XY, Yang WZ, Shi WC, Li DS, Zhang ZS, : Moyamoya disease in China: its clinical features and outcomes. Stroke 43:56\u201360, 20122202002710.1161\/STROKEAHA.111.621300"},{"issue":"Suppl 2","key":"b8","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). Research Committee on Spontaneous Occlusion of the Circle of Willis (Moyamoya Disease) of the Ministry of Health and Welfare, Japan","volume":"99","author":"Fukui M","year":"1997","unstructured":"Fukui M: Guidelines for the diagnosis and treatment of spontaneous occlusion of the circle of Willis (\u2018moyamoya\u2019 disease). Research Committee on Spontaneous Occlusion of the Circle of Willis (Moyamoya Disease) of the Ministry of Health and Welfare, Japan. Clin Neurol Neurosurg 99 (Suppl 2):S238\u2013S240, 199710.1016\/S0303-8467(97)00082-69409446"},{"key":"b9","series-title":"Acta Neurochir (Wien)","doi-asserted-by":"publisher","first-page":"247","DOI":"10.1007\/s00701-012-1545-4","article-title":"Adult moyamoya after revascularization","volume":"155","author":"Gross BA","year":"2013","unstructured":"Gross BA, Du R: Adult moyamoya after revascularization. Acta Neurochir (Wien) 155:247\u2013254, 201310.1007\/s00701-012-1545-4"},{"key":"b10","series-title":"Neurol Med Chir (Tokyo)","doi-asserted-by":"publisher","first-page":"245","DOI":"10.2176\/nmc.52.245","article-title":"Guidelines for diagnosis and treatment of moyamoya disease (spontaneous occlusion of the circle of Willis)","volume":"52","author":"Hashimoto N","year":"2012","unstructured":"Hashimoto N, Tominaga T, Miyamoto S, Nagata I, Houkin K, Suzuki N: Guidelines for diagnosis and treatment of moyamoya disease (spontaneous occlusion of the circle of Willis). Neurol Med Chir (Tokyo) 52:245\u2013266, 201210.2176\/nmc.52.245"},{"key":"b11","series-title":"Neurol Med Chir (Tokyo)","doi-asserted-by":"publisher","first-page":"295","DOI":"10.2176\/nmc.52.295","article-title":"Epidemiological features of moyamoya disease in Japan","volume":"52","author":"Hoshino H","year":"2012","unstructured":"Hoshino H, Izawa Y, Suzuki N: Epidemiological features of moyamoya disease in Japan. Neurol Med Chir (Tokyo) 52:295\u2013298, 201210.2176\/nmc.52.295"},{"key":"b12","series-title":"Neurol Res","doi-asserted-by":"publisher","first-page":"886","DOI":"10.1179\/1743132815Y.0000000073","article-title":"Clinical features and outcomes in 154 patients with haemorrhagic moyamoya disease: comparison of conservative treatment and surgical revascularization","volume":"37","author":"Huang Z","year":"2015","unstructured":"Huang Z, Ding X, Men W, Zhang D, Zhao Y, Wang R, : Clinical features and outcomes in 154 patients with haemorrhagic moyamoya disease: comparison of conservative treatment and surgical revascularization. Neurol Res 37:886\u2013892, 201510.1179\/1743132815Y.000000007326159234"},{"key":"b13","series-title":"World Neurosurg","doi-asserted-by":"publisher","first-page":"691","DOI":"10.1016\/j.wneu.2015.01.016","article-title":"The importance of encephalo-myo-synangiosis in surgical revascularization strategies for moyamoya disease in children and adults","volume":"83","author":"Imai H","year":"2015","unstructured":"Imai H, Miyawaki S, Ono H, Nakatomi H, Yoshimoto Y, Saito N: The importance of encephalo-myo-synangiosis in surgical revascularization strategies for moyamoya disease in children and adults. World Neurosurg 83:691\u2013699, 201510.1016\/j.wneu.2015.01.01625655688"},{"key":"b14","series-title":"Cerebrovasc Dis","doi-asserted-by":"publisher","first-page":"94","DOI":"10.1159\/000356350","article-title":"Clinical course of asymptomatic adult moyamoya disease","volume":"37","author":"Jo KI","year":"2014","unstructured":"Jo KI, Yeon JY, Hong SC, Kim JS: Clinical course of asymptomatic adult moyamoya disease. Cerebrovasc Dis 37:94\u2013101, 20142443504510.1159\/000356350"},{"key":"b15","series-title":"Neurol Med Chir (Tokyo)","doi-asserted-by":"publisher","first-page":"333","DOI":"10.2176\/nmc.52.333","article-title":"Surgical treatment of moyamoya disease in adults: combined direct and indirect vs. indirect bypass surgery","volume":"52","author":"Kim DS","year":"2012","unstructured":"Kim DS, Huh PW, Kim HS, Kim IS, Choi S, Mok JH, : Surgical treatment of moyamoya disease in adults: combined direct and indirect vs. indirect bypass surgery. Neurol Med Chir (Tokyo) 52:333\u2013338, 201210.2176\/nmc.52.333"},{"key":"b16","series-title":"Neurosurgery","doi-asserted-by":"publisher","first-page":"840","DOI":"10.1227\/01.NEU.0000114140.41509.14","article-title":"Moyamoya disease among young patients: its aggressive clinical course and the role of active surgical treatment","volume":"54","author":"Kim SK","year":"2004","unstructured":"Kim SK, Seol HJ, Cho BK, Hwang YS, Lee DS, Wang KC: Moyamoya disease among young patients: its aggressive clinical course and the role of active surgical treatment. Neurosurgery 54:840\u2013846, 20041504664910.1227\/01.NEU.0000114140.41509.14"},{"key":"b17","series-title":"J Neurosurg","doi-asserted-by":"publisher","first-page":"976","DOI":"10.3171\/jns.2000.93.6.0976","article-title":"Long-term natural history of hemorrhagic moyamoya disease in 42 patients","volume":"93","author":"Kobayashi E","year":"2000","unstructured":"Kobayashi E, Saeki N, Oishi H, Hirai S, Yamaura A: Long-term natural history of hemorrhagic moyamoya disease in 42 patients. J Neurosurg 93:976\u2013980, 20001111787010.3171\/jns.2000.93.6.0976"},{"key":"b18","series-title":"Stroke","doi-asserted-by":"publisher","first-page":"3193","DOI":"10.1161\/STROKEAHA.107.513408","article-title":"Moyamoya disease in Europeans","volume":"39","author":"Kraemer M","year":"2008","unstructured":"Kraemer M, Heienbrok W, Berlit P: Moyamoya disease in Europeans. Stroke 39:3193\u20133200, 200810.1161\/STROKEAHA.107.51340818787200"},{"key":"b19","series-title":"Stroke","doi-asserted-by":"publisher","first-page":"42","DOI":"10.1161\/STROKEAHA.107.490714","article-title":"Prevalence and clinicoepidemiological features of moyamoya disease in Japan: findings from a nationwide epidemiological survey","volume":"39","author":"Kuriyama S","year":"2008","unstructured":"Kuriyama S, Kusaka Y, Fujimura M, Wakai K, Tamakoshi A, Hashimoto S, : Prevalence and clinicoepidemiological features of moyamoya disease in Japan: findings from a nationwide epidemiological survey. Stroke 39:42\u201347, 200810.1161\/STROKEAHA.107.49071418048855"},{"key":"b20","series-title":"Lancet Neurol","doi-asserted-by":"publisher","first-page":"1056","DOI":"10.1016\/S1474-4422(08)70240-0","article-title":"Moyamoya disease: current concepts and future perspectives","volume":"7","author":"Kuroda S","year":"2008","unstructured":"Kuroda S, Houkin K: Moyamoya disease: current concepts and future perspectives. Lancet Neurol 7:1056\u20131066, 200810.1016\/S1474-4422(08)70240-018940695"},{"key":"b21","series-title":"Acta Neurochir (Wien)","doi-asserted-by":"publisher","first-page":"1179","DOI":"10.1007\/s00701-012-1325-1","article-title":"Long-term follow-up results in 142 adult patients with moyamoya disease according to management modality","volume":"154","author":"Lee SB","year":"2012","unstructured":"Lee SB, Kim DS, Huh PW, Yoo DS, Lee TG, Cho KS: Long-term follow-up results in 142 adult patients with moyamoya disease according to management modality. Acta Neurochir (Wien) 154:1179\u20131187, 201210.1007\/s00701-012-1325-1"},{"key":"b22","series-title":"Stroke","doi-asserted-by":"publisher","first-page":"240","DOI":"10.1161\/STROKEAHA.115.010512","article-title":"Hemorrhagic moyamoya disease in children: clinical, angiographic features, and long-term surgical outcome","volume":"47","author":"Liu P","year":"2016","unstructured":"Liu P, Han C, Li DS, Lv XL, Li YX, Duan L: Hemorrhagic moyamoya disease in children: clinical, angiographic features, and long-term surgical outcome. Stroke 47:240\u2013243, 201610.1161\/STROKEAHA.115.01051226534975"},{"key":"b23","series-title":"J Neurol Neurosurg Psychiatry","doi-asserted-by":"publisher","first-page":"258","DOI":"10.1136\/jnnp-2012-302236","article-title":"Long term outcome after conservative and surgical treatment of haemorrhagic moyamoya disease","volume":"84","author":"Liu X","year":"2013","unstructured":"Liu X, Zhang D, Shuo W, Zhao Y, Wang R, Zhao J: Long term outcome after conservative and surgical treatment of haemorrhagic moyamoya disease. J Neurol Neurosurg Psychiatry 84:258\u2013265, 20132301244410.1136\/jnnp-2012-302236"},{"key":"b24","series-title":"J Neurosurg","doi-asserted-by":"publisher","first-page":"392","DOI":"10.3171\/2014.10.JNS132369","article-title":"Clinical features and long-term outcomes of moyamoya disease: a single-center experience with 528 cases in China","volume":"122","author":"Liu XJ","year":"2015","unstructured":"Liu XJ, Zhang D, Wang S, Zhao YL, Teo M, Wang R, : Clinical features and long-term outcomes of moyamoya disease: a single-center experience with 528 cases in China. J Neurosurg 122:392\u2013399, 201510.3171\/2014.10.JNS13236925423267"},{"key":"b25","article-title":"Direct versus indirect revascularization procedures for moyamoya disease: a comparative effectiveness study. J Neurosurg","author":"Macyszyn L","unstructured":"Macyszyn L, Attiah M, Ma TS, Ali Z, Faught R, Hossain A, : Direct versus indirect revascularization procedures for moyamoya disease: a comparative effectiveness study. J Neurosurg [epub ahead of print July 29, 2016. DOI: 10.3171\/2015.8.JNS15504]27471892"},{"key":"b26","series-title":"Neurol Med Chir (Tokyo)","doi-asserted-by":"publisher","first-page":"278","DOI":"10.2176\/nmc.52.278","article-title":"History of the development of surgical treatments for moyamoya disease","volume":"52","author":"Matsushima T","year":"2012","unstructured":"Matsushima T, Inoue K, Kawashima M, Inoue T: History of the development of surgical treatments for moyamoya disease. Neurol Med Chir (Tokyo) 52:278\u2013286, 201210.2176\/nmc.52.278"},{"key":"b27","series-title":"Clin Neurol Neurosurg","doi-asserted-by":"publisher","first-page":"199","DOI":"10.1016\/j.clineuro.2009.11.009","article-title":"Epidemiological and clinical features of moyamoya disease in Nanjing, China","volume":"112","author":"Miao W","year":"2010","unstructured":"Miao W, Zhao PL, Zhang YS, Liu HY, Chang Y, Ma J, : Epidemiological and clinical features of moyamoya disease in Nanjing, China. Clin Neurol Neurosurg 112:199\u2013203, 20102000451110.1016\/j.clineuro.2009.11.009"},{"key":"b28","series-title":"Stroke","doi-asserted-by":"publisher","first-page":"1415","DOI":"10.1161\/STROKEAHA.113.004386","article-title":"Effects of extracranial-intracranial bypass for patients with hemorrhagic moyamoya disease: results of the Japan Adult Moyamoya Trial","volume":"45","author":"Miyamoto S","year":"2014","unstructured":"Miyamoto S, Yoshimoto T, Hashimoto N, Okada Y, Tsuji I, Tominaga T, : Effects of extracranial-intracranial bypass for patients with hemorrhagic moyamoya disease: results of the Japan Adult Moyamoya Trial. Stroke 45:1415\u20131421, 20142466820310.1161\/STROKEAHA.113.004386"},{"key":"b29","series-title":"J Neurol Sci","doi-asserted-by":"publisher","first-page":"381","DOI":"10.1016\/j.jns.2015.11.018","article-title":"Long term outcome and predictors of ischemic stroke recurrence in adult moyamoya disease","volume":"359","author":"Noh HJ","year":"2015","unstructured":"Noh HJ, Kim SJ, Kim JS, Hong SC, Kim KH, Jun P, : Long term outcome and predictors of ischemic stroke recurrence in adult moyamoya disease. J Neurol Sci 359:381\u2013388, 20152667114610.1016\/j.jns.2015.11.018"},{"key":"b30","series-title":"Childs Nerv Syst","doi-asserted-by":"publisher","first-page":"1281","DOI":"10.1007\/s00381-011-1469-y","article-title":"Natural history and progression factors of unilateral moyamoya disease in pediatric patients","volume":"27","author":"Park EK","year":"2011","unstructured":"Park EK, Lee YH, Shim KW, Choi JU, Kim DS: Natural history and progression factors of unilateral moyamoya disease in pediatric patients. Childs Nerv Syst 27:1281\u20131287, 201110.1007\/s00381-011-1469-y21552998"},{"key":"b31","series-title":"Medicine (Baltimore)","doi-asserted-by":"publisher","first-page":"e2218","DOI":"10.1097\/MD.0000000000002218","article-title":"The efficacy of surgical treatment for the secondary prevention of stroke in symptomatic moyamoya disease: a meta-analysis","volume":"94","author":"Qian C","year":"2015","unstructured":"Qian C, Yu X, Li J, Chen J, Wang L, Chen G: The efficacy of surgical treatment for the secondary prevention of stroke in symptomatic moyamoya disease: a meta-analysis. Medicine (Baltimore) 94:e2218, 201510.1097\/MD.0000000000002218"},{"key":"b32","series-title":"J Neurosurg","doi-asserted-by":"publisher","first-page":"308","DOI":"10.3171\/2015.7.JNS15218","article-title":"Surgical outcomes following encephaloduroarteriosynangiosis in adult moyamoya disease associated with Type 2 diabetes","volume":"125","author":"Ren B","year":"2016","unstructured":"Ren B, Zhang ZS, Liu WW, Bao XY, Li DS, Han C, : Surgical outcomes following encephaloduroarteriosynangiosis in adult moyamoya disease associated with Type 2 diabetes. J Neurosurg 125:308\u2013314, 20162674549110.3171\/2015.7.JNS15218"},{"key":"b33","series-title":"N Engl J Med","doi-asserted-by":"publisher","first-page":"1226","DOI":"10.1056\/NEJMra0804622","article-title":"Moyamoya disease and moyamoya syndrome","volume":"360","author":"Scott RM","year":"2009","unstructured":"Scott RM, Smith ER: Moyamoya disease and moyamoya syndrome. N Engl J Med 360:1226\u20131237, 20091929757510.1056\/NEJMra0804622"},{"key":"b34","series-title":"J Neurol Sci","doi-asserted-by":"publisher","first-page":"99","DOI":"10.1016\/j.jns.2013.10.014","article-title":"Moyamoya disease: a comparison of long term outcome of conservative and surgical treatment in India","volume":"336","author":"Sundaram S","year":"2014","unstructured":"Sundaram S, Sylaja PN, Menon G, Sudhir J, Jayadevan ER, Sukumaran S, : Moyamoya disease: a comparison of long term outcome of conservative and surgical treatment in India. J Neurol Sci 336:99\u2013102, 201410.1016\/j.jns.2013.10.01424183032"}],"container-title":["Journal of Neurosurgery"],"original-title":[],"link":[{"URL":"https:\/\/thejns.org\/view\/journals\/j-neurosurg\/128\/5\/article-p1327.xml","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/thejns.org\/downloadpdf\/journals\/j-neurosurg\/128\/5\/article-p1327.xml","content-type":"text\/html","content-version":"vor","intended-application":"syndication"},{"URL":"https:\/\/thejns.org\/downloadpdf\/journals\/j-neurosurg\/128\/5\/article-p1327.xml","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,3,31]],"date-time":"2025-03-31T05:57:23Z","timestamp":1743400643000},"score":1,"resource":{"primary":{"URL":"https:\/\/thejns.org\/view\/journals\/j-neurosurg\/128\/5\/article-p1327.xml"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2018,5]]},"references-count":34,"journal-issue":{"issue":"5"},"URL":"https:\/\/doi.org\/10.3171\/2016.12.jns162626","relation":{},"ISSN":["0022-3085","1933-0693"],"issn-type":[{"value":"0022-3085","type":"print"},{"value":"1933-0693","type":"electronic"}],"subject":[],"published":{"date-parts":[[2018,5]]}}}