{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,29]],"date-time":"2026-10-29T00:05:14Z","timestamp":1793232314117,"version":"4.5.0"},"reference-count":26,"publisher":"Journal of Neurosurgery Publishing Group (JNSPG)","issue":"5","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2023,11,1]]},"abstract":"<jats:sec>\n<jats:title>OBJECTIVE<\/jats:title>\n<jats:p>This study aimed to explore the long-term course of posterior circulation changes and predictors in patients with moyamoya disease (MMD).<\/jats:p>\n<\/jats:sec>\n<jats:sec>\n<jats:title>METHODS<\/jats:title>\n<jats:p>The authors retrospectively enrolled patients who were diagnosed with MMD and underwent encephaloduroarteriosynangiosis (EDAS) surgery at the authors\u2019 department from December 2002 to September 2011. A comparative study between short-term (6\u201312 months) and long-term (\u2265 9 years) follow-up angiography was conducted. The progression of lesions was defined from lower to higher stages of the posterior cerebral artery (PCA).<\/jats:p>\n<\/jats:sec>\n<jats:sec>\n<jats:title>RESULTS<\/jats:title>\n<jats:p>Eighty-eight patients who received indirect EDAS were enrolled in the study. The mean age at first surgery was 28.1 \u00b1 15.0 years. Among these 88 patients with MMD, 39 (44.3%) exhibited transient ischemic attack and 27 (30.7%) exhibited infarction, comprising 5 with occipital lobe infarction, 14 (15.9%) with hemorrhagic symptoms, and 8 (9.1%) with atypical symptoms as the initial symptoms. Heterozygous mutations occurred significantly more frequently in the cases that presented with PCA involvement. During follow-up, stage progression of PCA was observed in 21 patients (28 hemispheres). At short-term follow-up, 21\/176 (11.9%) hemispheres had progression of steno-occlusive lesions in the PCA. At long-term follow-up, 7 (4.0%) hemispheres had progression of steno-occlusive lesions in the PCA. At short-term follow-up, the progression of steno-occlusive lesions in the PCA was associated with progression of the internal carotid artery. Stage progression of PCA occurred significantly more frequently in the cases with PCA involvement on preoperative angiography. Nine strokes (10.2%) occurred in 88 patients during long-term follow-up. Four patients (4.5%) presented with ischemic stroke, including 2 with occipital lobe infarctions.<\/jats:p>\n<\/jats:sec>\n<jats:sec>\n<jats:title>CONCLUSIONS<\/jats:title>\n<jats:p>Progression of PCA stenosis is common in patients with MMD, even if the PCA is normal initially. Mutations of <jats:italic>RNF213<\/jats:italic> p.R4810K may predict PCA involvement or progression. Follow-up of the PCA in MMD patients should be conducted, and timely surgical revascularization is needed.<\/jats:p>\n<\/jats:sec>","DOI":"10.3171\/2023.2.jns222649","type":"journal-article","created":{"date-parts":[[2023,4,7]],"date-time":"2023-04-07T19:39:20Z","timestamp":1680896360000},"page":"1281-1286","source":"Crossref","is-referenced-by-count":11,"title":["A long-term study of posterior circulation changes after revascularization in patients with moyamoya disease"],"prefix":"10.3171","volume":"139","author":[{"given":"Xiang-Yang","family":"Bao","sequence":"first","affiliation":[{"name":"Department of Neurosurgery, The First Medical Centre, Chinese PLA General Hospital, Beijing, China;"},{"name":"Medical School of Chinese PLA, Beijing, China;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Huai-Yu","family":"Tong","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, The First Medical Centre, Chinese PLA General Hospital, Beijing, China;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Qian-Nan","family":"Wang","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, the Eighth Medical Centre, Chinese PLA General Hospital, Beijing, China; and"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xiao-Peng","family":"Wang","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, The First Medical Centre, Chinese PLA General Hospital, Beijing, China;"},{"name":"Medical School of Chinese PLA, Beijing, China;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gan","family":"Gao","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, The First Medical Centre, Chinese PLA General Hospital, Beijing, China;"},{"name":"Medical School of Chinese PLA, Beijing, China;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Qian","family":"Zhang","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, the Fifth Medical Centre, Chinese PLA General Hospital, Beijing, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Zheng-Xing","family":"Zou","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, The First Medical Centre, Chinese PLA General Hospital, Beijing, China;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lian","family":"Duan","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, The First Medical Centre, Chinese PLA General Hospital, Beijing, China;"},{"name":"Medical School of Chinese PLA, Beijing, China;"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1754","reference":[{"issue":"3","key":"b1","series-title":"Arch Neurol","first-page":"288","article-title":"Disease showing abnormal net-like vessels in base of brain","volume":"20","author":"Suzuki J","year":"1969","unstructured":"Suzuki J, Takaku A. 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