{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,27]],"date-time":"2026-06-27T02:46:28Z","timestamp":1782528388497,"version":"3.54.5"},"reference-count":54,"publisher":"Journal of Neurosurgery Publishing Group (JNSPG)","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2026,5,8]]},"abstract":"<jats:sec>\n                    <jats:title>OBJECTIVE<\/jats:title>\n                    <jats:p>The aim of this study was to evaluate whether indirect revascularization is associated with a reduction in systemic blood pressure (BP) over time in pediatric patients with moyamoya.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>METHODS<\/jats:title>\n                    <jats:p>This is a retrospective cohort study of pediatric patients with moyamoya who were treated at a single institution between June 2019 and January 2025. BP measurements were collected preoperatively (preadmission clinic evaluation) and postoperatively (outpatient follow-up evaluation at \u2265 3 months). BP was categorized as hypertensive or normotensive based on percentile thresholds adjusted for age, sex, and height, with measurements at the 95th and 99th percentiles indicating hypertension. The chi-square test was used to assess changes in hypertensive classification, and the paired t-test was used to compare mean absolute BP values at the two time points.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>RESULTS<\/jats:title>\n                    <jats:p>Overall, 63 children (39 female, mean age 11 years) with moyamoya who underwent indirect revascularization surgery were included in this analysis. The mean follow-up duration was 20.8 months. Preoperatively, 21 patients (33.9%) were classified as hypertensive for systolic BP and 9 (14.5%) for diastolic BP. These measurements were acquired preoperatively at a mean of 3.5 months (range 1 day to 11 months). Postoperatively, the proportion of hypertensive patients decreased to 10 (16.1%) and 3 (4.8%) for systolic BP and diastolic BP (p = 0.02 and 0.06, respectively). There was no significant change between the preoperative and postoperative mean arterial pressure measurements (77.3 mm Hg vs 76.2 mm Hg, respectively; p = 0.52).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>CONCLUSIONS<\/jats:title>\n                    <jats:p>Indirect revascularization surgery in pediatric patients with moyamoya was associated with a reduction in hypertension over time. This might reflect the delayed physiological effect of indirect revascularization, in which neovascularization and improved cerebral perfusion typically develop 3\u20136 months after surgery. Understanding BP changes following surgery might help avoid unnecessary use of antihypertensive drugs, which carry risk of precipitating hypotension and thus stroke.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.3171\/2026.1.peds25565","type":"journal-article","created":{"date-parts":[[2026,5,9]],"date-time":"2026-05-09T02:25:53Z","timestamp":1778293553000},"page":"1-5","source":"Crossref","is-referenced-by-count":0,"title":["Reduction of systemic hypertension following cerebral revascularization surgery for children with moyamoya"],"prefix":"10.3171","author":[{"given":"Taqwa","family":"Ahmad","sequence":"first","affiliation":[{"name":"University College London Medical School, London;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lauren","family":"Harris","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Great Ormond Street Hospital for Children NHS Foundation Trust, London;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Vijeya","family":"Ganesan","sequence":"additional","affiliation":[{"name":"UCL Great Ormond Street Institute of Child Health, London;"},{"name":"Department of Neurology, Great Ormond Street Hospital for Children NHS Foundation Trust, London; and"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Claire","family":"Toolis","sequence":"additional","affiliation":[{"name":"Department of Neurology, Great Ormond Street Hospital for Children NHS Foundation Trust, London; and"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Adikarige Haritha Dulanka","family":"Silva","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Great Ormond Street Hospital for Children NHS Foundation Trust, London;"},{"name":"UCL Great Ormond Street Institute of Child Health, London;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Greg","family":"James","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Great Ormond Street Hospital for Children NHS Foundation Trust, London;"},{"name":"UCL Great Ormond Street Institute of Child Health, London;"},{"name":"Department of Neuroscience, Physiology and Pharmacology, University College London, United Kingdom"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1754","reference":[{"issue":"4","key":"b1","series-title":"Neurosurg Focus","first-page":"E11","article-title":"Moyamoya disease: a summary","volume":"26","author":"Burke GM","year":"2009","unstructured":"Burke GM, Burke AM, Sherma AK, Hurley MC, Batjer HH, Bendok BR. Moyamoya disease: a summary. Neurosurg Focus. 2009;26(4):E11. doi:10.3171\/2009.1.FOCUS08310"},{"issue":"3","key":"b2","series-title":"Neurosurg Clin N Am","first-page":"543","article-title":"Moyamoya: epidemiology, presentation, and diagnosis","volume":"21","author":"Smith ER","year":"2010","unstructured":"Smith ER, Scott RM. Moyamoya: epidemiology, presentation, and diagnosis. Neurosurg Clin N Am. 2010;21(3):543\u2013551. doi:10.1016\/j.nec.2010.03.007"},{"issue":"1","key":"b3","series-title":"J Stroke","first-page":"2","article-title":"Moyamoya disease: epidemiology, clinical features, and diagnosis","volume":"18","author":"Kim JS","year":"2016","unstructured":"Kim JS. Moyamoya disease: epidemiology, clinical features, and diagnosis. J Stroke. 2016;18(1):2\u201311. doi:10.5853\/jos.2015.01627"},{"key":"b4","article-title":"Moyamoya disease. In: StatPearls","author":"Karsonovich T","year":"2025","unstructured":"Karsonovich T, Lui F. Moyamoya disease. In: StatPearls. StatPearls Publishing;2025.Accessed September 24, 2025. https:\/\/www.ncbi.nlm.nih.gov\/books\/NBK535455\/"},{"issue":"3","key":"b5","series-title":"Exp Ther Med","first-page":"1977","article-title":"Epidemiology, diagnosis and treatment of moyamoya disease","volume":"17","author":"Zhang H","year":"2019","unstructured":"Zhang H, Zheng L, Feng L. Epidemiology, diagnosis and treatment of moyamoya disease. Exp Ther Med. 2019;17(3):1977\u20131984. doi:10.3892\/etm.2019.7198"},{"issue":"1","key":"b6","series-title":"Radiol Bras","first-page":"31","article-title":"Moyamoya disease and syndrome: a review","volume":"55","author":"Demartini Z Jr","year":"2022","unstructured":"Demartini Z Jr, Teixeira BCA, Koppe GL, Gatto LAM, Roman A, Munhoz RP. Moyamoya disease and syndrome: a review. Radiol Bras. 2022;55(1):31\u201337. doi:10.1590\/0100-3984.2021.0010"},{"key":"b7","series-title":"Pediatr Neurol","first-page":"3","article-title":"Pediatric stroke: unique implications of the immature brain on injury and recovery","volume":"102","author":"Malone LA","year":"2020","unstructured":"Malone LA, Felling RJ. Pediatric stroke: unique implications of the immature brain on injury and recovery. Pediatr Neurol. 2020;102:3\u20139. doi:10.1016\/j.pediatrneurol.2019.06.016"},{"issue":"2","key":"b8","series-title":"Neurology","first-page":"189","article-title":"Risk of stroke in children: ethnic and gender disparities","volume":"61","author":"Fullerton HJ","year":"2003","unstructured":"Fullerton HJ, Wu YW, Zhao S, Johnston SC. Risk of stroke in children: ethnic and gender disparities. Neurology. 2003;61(2):189\u2013194. doi:10.1212\/01.wnl.0000078894.79866.95"},{"issue":"5","key":"b9","series-title":"J Neurosurg","first-page":"1523","article-title":"Direct versus indirect revascularization procedures for moyamoya disease: a comparative effectiveness study","volume":"126","author":"Macyszyn L","year":"2017","unstructured":"Macyszyn L, Attiah M, Ma TS,  Direct versus indirect revascularization procedures for moyamoya disease: a comparative effectiveness study. J Neurosurg. 2017;126(5):1523\u20131529. doi:10.3171\/2015.8.JNS15504"},{"issue":"5","key":"b10","series-title":"Childs Nerv Syst","first-page":"1225","article-title":"Surgical revascularizations for pediatric moyamoya: a systematic review, meta-analysis, and meta-regression analysis","volume":"39","author":"Lee KS","year":"2023","unstructured":"Lee KS, Zhang JJY, Bhate S,  Surgical revascularizations for pediatric moyamoya: a systematic review, meta-analysis, and meta-regression analysis. Childs Nerv Syst. 2023;39(5):1225\u20131243. doi:10.1007\/s00381-023-05868-6"},{"key":"b11","series-title":"Front Neurol","first-page":"861187","article-title":"Recognition of the effect of indirect revascularization for moyamoya disease: the balance between the stage progression and neoangiogenesis","volume":"13","author":"Bao XY","year":"2022","unstructured":"Bao XY, Wang QN, Wang XP,  Recognition of the effect of indirect revascularization for moyamoya disease: the balance between the stage progression and neoangiogenesis. Front Neurol. 2022;13:861187. doi:10.3389\/fneur.2022.861187"},{"issue":"2","key":"b12","series-title":"J Neurosurg Pediatr","first-page":"131","article-title":"High prevalence of systemic hypertension in pediatric patients with moyamoya disease years after surgical treatment","volume":"25","author":"Lee J","year":"2020","unstructured":"Lee J, Kim SK, Kang HG,  High prevalence of systemic hypertension in pediatric patients with moyamoya disease years after surgical treatment. J Neurosurg Pediatr. 2020;25(2):131\u2013137. doi:10.3171\/2019.9.PEDS1986"},{"issue":"3","key":"b13","series-title":"Stroke Vasc Interv Neurol","first-page":"e001176","article-title":"Prevalence of systemic hypertension and the effects of cerebral revascularization in patients with moyamoya disease","volume":"4","author":"Lee H","year":"2024","unstructured":"Lee H, Ahmed U, Bell-Stephens T, Steinberg GK. Prevalence of systemic hypertension and the effects of cerebral revascularization in patients with moyamoya disease. Stroke Vasc Interv Neurol. 2024;4(3):e001176. doi:10.1161\/SVIN.123.001176"},{"issue":"13","key":"b14","series-title":"J Clin Med","first-page":"4219","article-title":"The development and effect of systemic hypertension on clinical and radiological outcome in adult moyamoya angiopathy following revascularization surgery: experience of a single European institution","volume":"12","author":"Lucia K","year":"2023","unstructured":"Lucia K, Acker G, Rubarth K, Beyaztas D, Vajkoczy P. The development and effect of systemic hypertension on clinical and radiological outcome in adult moyamoya angiopathy following revascularization surgery: experience of a single European institution. J Clin Med. 2023;12(13):4219. doi:10.3390\/jcm12134219"},{"issue":"6","key":"b15","series-title":"J Cereb Blood Flow Metab","first-page":"1472","article-title":"Impact of blood pressure changes in cerebral blood perfusion of patients with ischemic Moyamoya disease evaluated by SPECT","volume":"41","author":"Liming Z","year":"2021","unstructured":"Liming Z, Weiliang S, Jia J,  Impact of blood pressure changes in cerebral blood perfusion of patients with ischemic Moyamoya disease evaluated by SPECT. J Cereb Blood Flow Metab. 2021;41(6):1472\u20131480. doi:10.1177\/0271678X20967458"},{"issue":"6","key":"b16","series-title":"Stroke","first-page":"1170","article-title":"Effects of surgical revascularization on outcome of patients with pediatric moyamoya disease","volume":"28","author":"Ishikawa T","year":"1997","unstructured":"Ishikawa T, Houkin K, Kamiyama H, Abe H. Effects of surgical revascularization on outcome of patients with pediatric moyamoya disease. Stroke. 1997;28(6):1170\u20131173. doi:10.1161\/01.str.28.6.1170"},{"issue":"5","key":"b17","series-title":"Hypertension","first-page":"1116","article-title":"Update: ambulatory blood pressure monitoring in children and adolescents: a scientific statement from the American Heart Association","volume":"63","author":"Flynn JT","year":"2014","unstructured":"Flynn JT, Daniels SR, Hayman LL,  Update: ambulatory blood pressure monitoring in children and adolescents: a scientific statement from the American Heart Association. Hypertension. 2014;63(5):1116\u20131135. doi:10.1161\/HYP.0000000000000007"},{"issue":"3","key":"b18","series-title":"Pediatrics","first-page":"e20171904","article-title":"Clinical practice guideline for screening and management of high blood pressure in children and adolescents","volume":"140","author":"Flynn JT","year":"2017","unstructured":"Flynn JT, Kaelber DC, Baker-Smith CM,  Clinical practice guideline for screening and management of high blood pressure in children and adolescents. Pediatrics. 2017;140(3):e20171904. doi:10.1542\/peds.2017-1904"},{"issue":"9","key":"b19","series-title":"J Hypertens","first-page":"1719","article-title":"Management of high blood pressure in children and adolescents: recommendations of the European Society of Hypertension","volume":"27","author":"Lurbe E","year":"2009","unstructured":"Lurbe E, Cifkova R, Cruickshank JK,  Management of high blood pressure in children and adolescents: recommendations of the European Society of Hypertension. J Hypertens. 2009;27(9):1719\u20131742. doi:10.1097\/HJH.0b013e32832f4f6b"},{"issue":"1","key":"b20","series-title":"Pediatr Nephrol","first-page":"17","article-title":"Hypertension in infancy: diagnosis, management and outcome","volume":"27","author":"Dionne JM","year":"2012","unstructured":"Dionne JM, Abitbol CL, Flynn JT. Hypertension in infancy: diagnosis, management and outcome. Pediatr Nephrol. 2012;27(1):17\u201332. doi:10.1007\/s00467-010-1755-z"},{"issue":"1","key":"b21","series-title":"Sci Rep","first-page":"12364","article-title":"Vascular risk profile and changes of arterial hypertension after surgical revascularization in adult Moyamoya patients","volume":"14","author":"Haas P","year":"2024","unstructured":"Haas P, Wiggenhauser LM, Tellermann J,  Vascular risk profile and changes of arterial hypertension after surgical revascularization in adult Moyamoya patients. Sci Rep. 2024;14(1):12364. doi:10.1038\/s41598-024-61966-8"},{"issue":"12","key":"b22","series-title":"Arch Dis Child","first-page":"1177","article-title":"Brain revascularisation in hypertension","volume":"60","author":"Willems CE","year":"1985","unstructured":"Willems CE, Salisbury DM, Lumley JS, Dillon MJ. Brain revascularisation in hypertension. Arch Dis Child. 1985;60(12):1177\u20131179. doi:10.1136\/adc.60.12.1177"},{"issue":"7","key":"b23","series-title":"JAMA Pediatr","first-page":"688","article-title":"Long-term cardiovascular outcomes in children and adolescents with hypertension","volume":"178","author":"Robinson CH","year":"2024","unstructured":"Robinson CH, Hussain J, Jeyakumar N,  Long-term cardiovascular outcomes in children and adolescents with hypertension. JAMA Pediatr. 2024;178(7):688\u2013698. doi:10.1001\/jamapediatrics.2024.1543"},{"issue":"6","key":"b24","series-title":"Hypertension","first-page":"1089","article-title":"Adverse outcomes in pediatric hypertension","volume":"70","author":"Daniels SR","year":"2017","unstructured":"Daniels SR. Adverse outcomes in pediatric hypertension. Hypertension. 2017;70(6):1089\u20131090. doi:10.1161\/HYPERTENSIONAHA.117.09784"},{"issue":"3","key":"b25","series-title":"J Stroke","first-page":"332","article-title":"Cognitive functions in children and adults with moyamoya vasculopathy: a systematic review and meta-analysis","volume":"20","author":"Kronenburg A","year":"2018","unstructured":"Kronenburg A, van den Berg E, van Schooneveld MM,  Cognitive functions in children and adults with moyamoya vasculopathy: a systematic review and meta-analysis. J Stroke. 2018;20(3):332\u2013341. doi:10.5853\/jos.2018.01550"},{"issue":"11","key":"b26","series-title":"Stroke","first-page":"3177","article-title":"Long-term outcomes of indirect bypass for 629 children with moyamoya disease","volume":"50","author":"Ha EJ","year":"2019","unstructured":"Ha EJ, Kim KH, Wang KC,  Long-term outcomes of indirect bypass for 629 children with moyamoya disease. Stroke. 2019;50(11):3177\u20133183. doi:10.1161\/STROKEAHA.119.025609"},{"issue":"5","key":"b27","series-title":"Kidney Int Rep","first-page":"954","article-title":"High blood pressure in children and adolescents: current perspectives and strategies to improve future kidney and cardiovascular health","volume":"7","author":"Robinson CH","year":"2022","unstructured":"Robinson CH, Chanchlani R. High blood pressure in children and adolescents: current perspectives and strategies to improve future kidney and cardiovascular health. Kidney Int Rep. 2022;7(5):954\u2013970. doi:10.1016\/j.ekir.2022.02.018"},{"issue":"4","key":"b1","series-title":"Neurosurg Focus","first-page":"E11","article-title":"Moyamoya disease: a summary","volume":"26","author":"Burke GM","year":"2009","unstructured":"Burke GM, Burke AM, Sherma AK, Hurley MC, Batjer HH, Bendok BR. Moyamoya disease: a summary. Neurosurg Focus. 2009;26(4):E11. doi:10.3171\/2009.1.FOCUS08310"},{"issue":"3","key":"b2","series-title":"Neurosurg Clin N Am","first-page":"543","article-title":"Moyamoya: epidemiology, presentation, and diagnosis","volume":"21","author":"Smith ER","year":"2010","unstructured":"Smith ER, Scott RM. Moyamoya: epidemiology, presentation, and diagnosis. Neurosurg Clin N Am. 2010;21(3):543\u2013551. doi:10.1016\/j.nec.2010.03.007"},{"issue":"1","key":"b3","series-title":"J Stroke","first-page":"2","article-title":"Moyamoya disease: epidemiology, clinical features, and diagnosis","volume":"18","author":"Kim JS","year":"2016","unstructured":"Kim JS. Moyamoya disease: epidemiology, clinical features, and diagnosis. J Stroke. 2016;18(1):2\u201311. doi:10.5853\/jos.2015.01627"},{"key":"b4","article-title":"Moyamoya disease. In: StatPearls","author":"Karsonovich T","year":"2025","unstructured":"Karsonovich T, Lui F. Moyamoya disease. In: StatPearls. StatPearls Publishing;2025.Accessed September 24, 2025. https:\/\/www.ncbi.nlm.nih.gov\/books\/NBK535455\/"},{"issue":"3","key":"b5","series-title":"Exp Ther Med","first-page":"1977","article-title":"Epidemiology, diagnosis and treatment of moyamoya disease","volume":"17","author":"Zhang H","year":"2019","unstructured":"Zhang H, Zheng L, Feng L. Epidemiology, diagnosis and treatment of moyamoya disease. Exp Ther Med. 2019;17(3):1977\u20131984. doi:10.3892\/etm.2019.7198"},{"issue":"1","key":"b6","series-title":"Radiol Bras","first-page":"31","article-title":"Moyamoya disease and syndrome: a review","volume":"55","author":"Demartini Z Jr","year":"2022","unstructured":"Demartini Z Jr, Teixeira BCA, Koppe GL, Gatto LAM, Roman A, Munhoz RP. Moyamoya disease and syndrome: a review. Radiol Bras. 2022;55(1):31\u201337. doi:10.1590\/0100-3984.2021.0010"},{"key":"b7","series-title":"Pediatr Neurol","first-page":"3","article-title":"Pediatric stroke: unique implications of the immature brain on injury and recovery","volume":"102","author":"Malone LA","year":"2020","unstructured":"Malone LA, Felling RJ. Pediatric stroke: unique implications of the immature brain on injury and recovery. Pediatr Neurol. 2020;102:3\u20139. doi:10.1016\/j.pediatrneurol.2019.06.016"},{"issue":"2","key":"b8","series-title":"Neurology","first-page":"189","article-title":"Risk of stroke in children: ethnic and gender disparities","volume":"61","author":"Fullerton HJ","year":"2003","unstructured":"Fullerton HJ, Wu YW, Zhao S, Johnston SC. Risk of stroke in children: ethnic and gender disparities. Neurology. 2003;61(2):189\u2013194. doi:10.1212\/01.wnl.0000078894.79866.95"},{"issue":"5","key":"b9","series-title":"J Neurosurg","first-page":"1523","article-title":"Direct versus indirect revascularization procedures for moyamoya disease: a comparative effectiveness study","volume":"126","author":"Macyszyn L","year":"2017","unstructured":"Macyszyn L, Attiah M, Ma TS,  Direct versus indirect revascularization procedures for moyamoya disease: a comparative effectiveness study. J Neurosurg. 2017;126(5):1523\u20131529. doi:10.3171\/2015.8.JNS15504"},{"issue":"5","key":"b10","series-title":"Childs Nerv Syst","first-page":"1225","article-title":"Surgical revascularizations for pediatric moyamoya: a systematic review, meta-analysis, and meta-regression analysis","volume":"39","author":"Lee KS","year":"2023","unstructured":"Lee KS, Zhang JJY, Bhate S,  Surgical revascularizations for pediatric moyamoya: a systematic review, meta-analysis, and meta-regression analysis. Childs Nerv Syst. 2023;39(5):1225\u20131243. doi:10.1007\/s00381-023-05868-6"},{"key":"b11","series-title":"Front Neurol","first-page":"861187","article-title":"Recognition of the effect of indirect revascularization for moyamoya disease: the balance between the stage progression and neoangiogenesis","volume":"13","author":"Bao XY","year":"2022","unstructured":"Bao XY, Wang QN, Wang XP,  Recognition of the effect of indirect revascularization for moyamoya disease: the balance between the stage progression and neoangiogenesis. Front Neurol. 2022;13:861187. doi:10.3389\/fneur.2022.861187"},{"issue":"2","key":"b12","series-title":"J Neurosurg Pediatr","first-page":"131","article-title":"High prevalence of systemic hypertension in pediatric patients with moyamoya disease years after surgical treatment","volume":"25","author":"Lee J","year":"2020","unstructured":"Lee J, Kim SK, Kang HG,  High prevalence of systemic hypertension in pediatric patients with moyamoya disease years after surgical treatment. J Neurosurg Pediatr. 2020;25(2):131\u2013137. doi:10.3171\/2019.9.PEDS1986"},{"issue":"3","key":"b13","series-title":"Stroke Vasc Interv Neurol","first-page":"e001176","article-title":"Prevalence of systemic hypertension and the effects of cerebral revascularization in patients with moyamoya disease","volume":"4","author":"Lee H","year":"2024","unstructured":"Lee H, Ahmed U, Bell-Stephens T, Steinberg GK. Prevalence of systemic hypertension and the effects of cerebral revascularization in patients with moyamoya disease. Stroke Vasc Interv Neurol. 2024;4(3):e001176. doi:10.1161\/SVIN.123.001176"},{"issue":"13","key":"b14","series-title":"J Clin Med","first-page":"4219","article-title":"The development and effect of systemic hypertension on clinical and radiological outcome in adult moyamoya angiopathy following revascularization surgery: experience of a single European institution","volume":"12","author":"Lucia K","year":"2023","unstructured":"Lucia K, Acker G, Rubarth K, Beyaztas D, Vajkoczy P. The development and effect of systemic hypertension on clinical and radiological outcome in adult moyamoya angiopathy following revascularization surgery: experience of a single European institution. J Clin Med. 2023;12(13):4219. doi:10.3390\/jcm12134219"},{"issue":"6","key":"b15","series-title":"J Cereb Blood Flow Metab","first-page":"1472","article-title":"Impact of blood pressure changes in cerebral blood perfusion of patients with ischemic Moyamoya disease evaluated by SPECT","volume":"41","author":"Liming Z","year":"2021","unstructured":"Liming Z, Weiliang S, Jia J,  Impact of blood pressure changes in cerebral blood perfusion of patients with ischemic Moyamoya disease evaluated by SPECT. J Cereb Blood Flow Metab. 2021;41(6):1472\u20131480. doi:10.1177\/0271678X20967458"},{"issue":"6","key":"b16","series-title":"Stroke","first-page":"1170","article-title":"Effects of surgical revascularization on outcome of patients with pediatric moyamoya disease","volume":"28","author":"Ishikawa T","year":"1997","unstructured":"Ishikawa T, Houkin K, Kamiyama H, Abe H. Effects of surgical revascularization on outcome of patients with pediatric moyamoya disease. Stroke. 1997;28(6):1170\u20131173. doi:10.1161\/01.str.28.6.1170"},{"issue":"5","key":"b17","series-title":"Hypertension","first-page":"1116","article-title":"Update: ambulatory blood pressure monitoring in children and adolescents: a scientific statement from the American Heart Association","volume":"63","author":"Flynn JT","year":"2014","unstructured":"Flynn JT, Daniels SR, Hayman LL,  Update: ambulatory blood pressure monitoring in children and adolescents: a scientific statement from the American Heart Association. Hypertension. 2014;63(5):1116\u20131135. doi:10.1161\/HYP.0000000000000007"},{"issue":"3","key":"b18","series-title":"Pediatrics","first-page":"e20171904","article-title":"Clinical practice guideline for screening and management of high blood pressure in children and adolescents","volume":"140","author":"Flynn JT","year":"2017","unstructured":"Flynn JT, Kaelber DC, Baker-Smith CM,  Clinical practice guideline for screening and management of high blood pressure in children and adolescents. Pediatrics. 2017;140(3):e20171904. doi:10.1542\/peds.2017-1904"},{"issue":"9","key":"b19","series-title":"J Hypertens","first-page":"1719","article-title":"Management of high blood pressure in children and adolescents: recommendations of the European Society of Hypertension","volume":"27","author":"Lurbe E","year":"2009","unstructured":"Lurbe E, Cifkova R, Cruickshank JK,  Management of high blood pressure in children and adolescents: recommendations of the European Society of Hypertension. J Hypertens. 2009;27(9):1719\u20131742. doi:10.1097\/HJH.0b013e32832f4f6b"},{"issue":"1","key":"b20","series-title":"Pediatr Nephrol","first-page":"17","article-title":"Hypertension in infancy: diagnosis, management and outcome","volume":"27","author":"Dionne JM","year":"2012","unstructured":"Dionne JM, Abitbol CL, Flynn JT. Hypertension in infancy: diagnosis, management and outcome. Pediatr Nephrol. 2012;27(1):17\u201332. doi:10.1007\/s00467-010-1755-z"},{"issue":"1","key":"b21","series-title":"Sci Rep","first-page":"12364","article-title":"Vascular risk profile and changes of arterial hypertension after surgical revascularization in adult Moyamoya patients","volume":"14","author":"Haas P","year":"2024","unstructured":"Haas P, Wiggenhauser LM, Tellermann J,  Vascular risk profile and changes of arterial hypertension after surgical revascularization in adult Moyamoya patients. Sci Rep. 2024;14(1):12364. doi:10.1038\/s41598-024-61966-8"},{"issue":"12","key":"b22","series-title":"Arch Dis Child","first-page":"1177","article-title":"Brain revascularisation in hypertension","volume":"60","author":"Willems CE","year":"1985","unstructured":"Willems CE, Salisbury DM, Lumley JS, Dillon MJ. Brain revascularisation in hypertension. Arch Dis Child. 1985;60(12):1177\u20131179. doi:10.1136\/adc.60.12.1177"},{"issue":"7","key":"b23","series-title":"JAMA Pediatr","first-page":"688","article-title":"Long-term cardiovascular outcomes in children and adolescents with hypertension","volume":"178","author":"Robinson CH","year":"2024","unstructured":"Robinson CH, Hussain J, Jeyakumar N,  Long-term cardiovascular outcomes in children and adolescents with hypertension. JAMA Pediatr. 2024;178(7):688\u2013698. doi:10.1001\/jamapediatrics.2024.1543"},{"issue":"6","key":"b24","series-title":"Hypertension","first-page":"1089","article-title":"Adverse outcomes in pediatric hypertension","volume":"70","author":"Daniels SR","year":"2017","unstructured":"Daniels SR. Adverse outcomes in pediatric hypertension. Hypertension. 2017;70(6):1089\u20131090. doi:10.1161\/HYPERTENSIONAHA.117.09784"},{"issue":"3","key":"b25","series-title":"J Stroke","first-page":"332","article-title":"Cognitive functions in children and adults with moyamoya vasculopathy: a systematic review and meta-analysis","volume":"20","author":"Kronenburg A","year":"2018","unstructured":"Kronenburg A, van den Berg E, van Schooneveld MM,  Cognitive functions in children and adults with moyamoya vasculopathy: a systematic review and meta-analysis. J Stroke. 2018;20(3):332\u2013341. doi:10.5853\/jos.2018.01550"},{"issue":"11","key":"b26","series-title":"Stroke","first-page":"3177","article-title":"Long-term outcomes of indirect bypass for 629 children with moyamoya disease","volume":"50","author":"Ha EJ","year":"2019","unstructured":"Ha EJ, Kim KH, Wang KC,  Long-term outcomes of indirect bypass for 629 children with moyamoya disease. Stroke. 2019;50(11):3177\u20133183. doi:10.1161\/STROKEAHA.119.025609"},{"issue":"5","key":"b27","series-title":"Kidney Int Rep","first-page":"954","article-title":"High blood pressure in children and adolescents: current perspectives and strategies to improve future kidney and cardiovascular health","volume":"7","author":"Robinson CH","year":"2022","unstructured":"Robinson CH, Chanchlani R. High blood pressure in children and adolescents: current perspectives and strategies to improve future kidney and cardiovascular health. Kidney Int Rep. 2022;7(5):954\u2013970. doi:10.1016\/j.ekir.2022.02.018"}],"container-title":["Journal of Neurosurgery: Pediatrics"],"original-title":[],"link":[{"URL":"https:\/\/thejns.org\/view\/journals\/j-neurosurg-pediatr\/aop\/article-10.3171-2026.1.PEDS25565\/article-10.3171-2026.1.PEDS25565.xml","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/thejns.org\/downloadpdf\/journals\/j-neurosurg-pediatr\/aop\/article-10.3171-2026.1.PEDS25565\/article-10.3171-2026.1.PEDS25565.xml","content-type":"text\/html","content-version":"vor","intended-application":"syndication"},{"URL":"https:\/\/thejns.org\/downloadpdf\/journals\/j-neurosurg-pediatr\/aop\/article-10.3171-2026.1.PEDS25565\/article-10.3171-2026.1.PEDS25565.xml","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,6,27]],"date-time":"2026-06-27T02:09:02Z","timestamp":1782526142000},"score":1,"resource":{"primary":{"URL":"https:\/\/thejns.org\/view\/journals\/j-neurosurg-pediatr\/aop\/article-10.3171-2026.1.PEDS25565\/article-10.3171-2026.1.PEDS25565.xml"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,5,8]]},"references-count":54,"URL":"https:\/\/doi.org\/10.3171\/2026.1.peds25565","relation":{},"ISSN":["1933-0707","1933-0715"],"issn-type":[{"value":"1933-0707","type":"print"},{"value":"1933-0715","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,5,8]]}}}