{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,29]],"date-time":"2026-09-29T19:16:38Z","timestamp":1790709398215,"version":"4.1.0"},"reference-count":42,"publisher":"Journal of Neurosurgery Publishing Group (JNSPG)","issue":"2","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2018,8]]},"abstract":"<jats:sec><jats:title>OBJECTIVE<\/jats:title><jats:p>The object of this study was to summarize the long-term effect of encephaloduroarteriosynangiosis (EDAS) for the treatment of pediatric moyamoya disease (MMD) and to investigate factors influencing the clinical outcomes of EDAS.<\/jats:p><\/jats:sec><jats:sec><jats:title>METHODS<\/jats:title><jats:p>Clinical features, angiographic findings, and clinical outcomes were analyzed among MMD patients younger than 18 years who had been treated with EDAS between 2002 and 2007 at the authors\u2019 institution. The Kaplan-Meier method was used to estimate stroke risk after EDAS. Predictors of neurological outcome were assessed.<\/jats:p><\/jats:sec><jats:sec><jats:title>RESULTS<\/jats:title><jats:p>One hundred fifteen patients were identified. The mean age at symptom onset was 7.3 \u00b1 4.0 years. The incidence of familial MMD was 11.3%. The female\/male ratio was 1:1.16. A total of 232 EDAS procedures were performed, and the incidence of postoperative complications was 3%. Postoperative digital subtraction angiography was performed in 54% of the patients, and about 80% of the hemispheres showed good or excellent results. Neovascularization showed significant correlations with delay time (from symptom onset to first operation), Suzuki stage, and preoperative stroke (all p &lt; 0.05). Clinical follow-up was available in 100 patients with a mean follow-up of 124.4 \u00b1 10.5 months. Ten-year cumulative survival was 96.5% after surgery, and the risk of stroke was 0.33%\/person-year. An independent life with no significant disability was reported by 92% of the patients. A good outcome correlated with a low Suzuki stage (p = 0.001). Older children and those without preoperative stroke had better clinical outcomes (p &lt; 0.05).<\/jats:p><\/jats:sec><jats:sec><jats:title>CONCLUSIONS<\/jats:title><jats:p>On the basis of long-term follow-up data, the authors concluded that EDAS is a safe and effective treatment for pediatric MMD, can reduce the risk of subsequent neurological events, and can improve quality of life. The risk of ischemia-related complications was higher in younger patients, and older children showed better outcomes. Compensation was greater with more prominent cerebral ischemia. The long-term clinical outcome largely depended on the presence and extent of preoperative stroke.<\/jats:p><\/jats:sec>","DOI":"10.3171\/2018.2.peds17591","type":"journal-article","created":{"date-parts":[[2018,6,1]],"date-time":"2018-06-01T13:55:32Z","timestamp":1527861332000},"page":"173-180","source":"Crossref","is-referenced-by-count":35,"title":["Encephaloduroarteriosynangiosis for pediatric moyamoya disease: long-term follow-up of 100 cases at a single center"],"prefix":"10.3171","volume":"22","author":[{"given":"Yong","family":"Zhang","sequence":"first","affiliation":[{"name":"Department of Neurosurgery, 307th Hospital of People\u2019s Liberation Army, 307 Clinical College, Anhui Medical University; and"},{"name":"Department of Neurosurgery, 307th Hospital of People\u2019s Liberation Army, The Center for Cerebral Vascular Disease, PLA, Beijing, People\u2019s Republic of China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xiang-Yang","family":"Bao","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, 307th Hospital of People\u2019s Liberation Army, The Center for Cerebral Vascular Disease, PLA, Beijing, People\u2019s Republic of China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lian","family":"Duan","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, 307th Hospital of People\u2019s Liberation Army, 307 Clinical College, Anhui Medical University; and"},{"name":"Department of Neurosurgery, 307th Hospital of People\u2019s Liberation Army, The Center for Cerebral Vascular Disease, PLA, Beijing, People\u2019s Republic of China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Wei-Zhong","family":"Yang","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, 307th Hospital of People\u2019s Liberation Army, The Center for Cerebral Vascular Disease, PLA, Beijing, People\u2019s Republic of China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"De-Sheng","family":"Li","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, 307th Hospital of People\u2019s Liberation Army, The Center for Cerebral Vascular Disease, PLA, Beijing, People\u2019s Republic of China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Zheng-Shan","family":"Zhang","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, 307th Hospital of People\u2019s Liberation Army, The Center for Cerebral Vascular Disease, PLA, Beijing, People\u2019s Republic of China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Cong","family":"Han","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, 307th Hospital of People\u2019s Liberation Army, The Center for Cerebral Vascular Disease, PLA, Beijing, People\u2019s Republic of China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Feng","family":"Zhao","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, 307th Hospital of People\u2019s Liberation Army, The Center for Cerebral Vascular Disease, PLA, Beijing, People\u2019s Republic of China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Qian","family":"Zhang","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, 307th Hospital of People\u2019s Liberation Army, The Center for Cerebral Vascular Disease, PLA, Beijing, People\u2019s Republic of China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Qian-Nan","family":"Wang","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, 307th Hospital of People\u2019s Liberation Army, The Center for Cerebral Vascular Disease, PLA, Beijing, People\u2019s Republic of China"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1754","reference":[{"key":"b1","series-title":"Pediatr Neurosurg","doi-asserted-by":"publisher","first-page":"26","DOI":"10.1159\/000120932","article-title":"Pial synangiosis for moyamoya syndrome in children","volume":"23","author":"Adelson PD","year":"1995","unstructured":"Adelson PD, Scott RM: Pial synangiosis for moyamoya syndrome in children. 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