{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,1,18]],"date-time":"2026-01-18T02:09:56Z","timestamp":1768702196159,"version":"3.49.0"},"reference-count":20,"publisher":"Journal of Neurosurgery Publishing Group (JNSPG)","issue":"5","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2017,5]]},"abstract":"<jats:sec><jats:title>OBJECTIVE<\/jats:title><jats:p>Direct and indirect bypass surgeries are recognized as the most effective treatments for preventing further stroke in adults with moyamoya disease (MMD). However, the risk factors for postoperative infarction after bypass surgery for MMD are not well established. Therefore, the objective of this study was to investigate the risk factors for postoperative infarction. In particular, the authors sought to determine whether transcranial Doppler (TCD) ultrasonography measurements of mean flow velocity (MFV) in the middle cerebral artery (MCA) could predict postrevascularization infarction.<\/jats:p><\/jats:sec><jats:sec><jats:title>METHODS<\/jats:title><jats:p>The medical records of patients with MMD who underwent direct bypass surgery at the authors' institution between July 2012 and April 2015 were reviewed. The MFV in the MCA was measured with TCD ultrasonography and categorized as high (&gt; 80 cm\/sec), medium (40\u201380 cm\/sec), and low (&lt; 40 cm\/sec). Postoperative MRI, including diffusion-weighted imaging, was performed for all patients within a week of their surgery. Angiographic findings were classified according to the Suzuki scale. Postrevascularization infarction was defined as any diffusion restriction on postoperative MRI scans. Postoperative neurological status was assessed through a clinical chart review, and the modified Rankin Scale was used to evaluate clinical outcomes.<\/jats:p><\/jats:sec><jats:sec><jats:title>RESULTS<\/jats:title><jats:p>Of 43 hemispheres in which bypass surgery for MMD was performed, 11 showed postrevascularization infarction. Ten of these hemispheres had low MFV and 1 had medium MFV in the ipsilateral MCA. In both univariate and multivariate analyses, a low MFV was associated with postrevascularization infarction (adjusted OR 109.2, 95% CI 1.9\u20136245.3). A low MFV was also statistically significantly associated with more advanced MMD stage (p = 0.02).<\/jats:p><\/jats:sec><jats:sec><jats:title>CONCLUSIONS<\/jats:title><jats:p>A low MFV in the ipsilateral MCA may predict postrevascularization infarction. Bypass surgery for MMD appears to be safe in early-stage MMD. Results of TCD ultrasonography provide clinical data on the hemodynamics in MMD patients before and after revascularization.<\/jats:p><\/jats:sec>","DOI":"10.3171\/2016.3.jns152256","type":"journal-article","created":{"date-parts":[[2016,6,3]],"date-time":"2016-06-03T14:01:58Z","timestamp":1464962518000},"page":"1573-1577","source":"Crossref","is-referenced-by-count":14,"title":["Low flow velocity in the middle cerebral artery predicting infarction after bypass surgery in adult moyamoya disease"],"prefix":"10.3171","volume":"126","author":[{"given":"Hoyeon","family":"Cho","sequence":"first","affiliation":[{"name":"Department of Neurosurgery, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul; and"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Kyung Il","family":"Jo","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Hana General Hospital, Cheongju, Korea"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jua","family":"Yu","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul; and"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Je Young","family":"Yeon","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul; and"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Seung-Chyul","family":"Hong","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul; and"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jong Soo","family":"Kim","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul; and"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1754","reference":[{"key":"b1-jns152256","series-title":"Neurosurgery","first-page":"430","article-title":"Surgical outcomes for moyamoya angiopathy at Barrow Neurological Institute with comparison of adult indirect encephaloduroarteriosynangiosis bypass, adult direct superficial temporal artery-to-middle cerebral artery bypass, and pediatric bypass: 154 revascularization surgeries in 140 affected hemispheres","volume":"73","author":"Abla AA","year":"2013","unstructured":"Abla AA, Gandhoke G, Clark JC, Oppenlander ME, Velat GJ, Zabramski JM, : Surgical outcomes for moyamoya angiopathy at Barrow Neurological Institute with comparison of adult indirect encephaloduroarteriosynangiosis bypass, adult direct superficial temporal artery-to-middle cerebral artery bypass, and pediatric bypass: 154 revascularization surgeries in 140 affected hemispheres. 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