{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,2,3]],"date-time":"2026-02-03T10:57:25Z","timestamp":1770116245740,"version":"3.49.0"},"reference-count":40,"publisher":"Journal of Neurosurgery Publishing Group (JNSPG)","issue":"18","license":[{"start":{"date-parts":[[2025,5,5]],"date-time":"2025-05-05T00:00:00Z","timestamp":1746403200000},"content-version":"unspecified","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["J Cosmet Laser Ther"],"published-print":{"date-parts":[[2025,5,5]]},"abstract":"\n BACKGROUND<\/jats:title>\n The prevalence of aneurysm formation in adults with moyamoya disease (MMD) is higher than that in the general population. The treatment strategy is often individualized based on the patient\u2019s disease characteristics.<\/jats:p>\n <\/jats:sec>\n \n OBSERVATIONS<\/jats:title>\n The authors report the case of a man who presented with an intraparenchymal hemorrhage. Cerebral angiography showed a typical MMD pattern characterized by occlusion and severe stenosis at the terminal portions of the bilateral internal carotid arteries, accompanied by moyamoya-like vasodilation. The bilateral posterior cerebral arteries (PCAs) had collateral blood supply to the anterior circulation, and 5 aneurysms were observed, which is rare. Considering that revascularization through bypass surgery could alter the hemodynamic stresses associated with MMD, the authors performed bilateral extracranial-intracranial bypass surgeries to reconstruct the anterior circulation and reduce the blood flow burden on the vertebrobasilar system. Follow-up imaging demonstrated improved cerebral perfusion in both hemispheres. Importantly, 3 of the 5 aneurysms remained stable, 1 aneurysm had shrunk, and the other had completely resolved.<\/jats:p>\n <\/jats:sec>\n \n LESSONS<\/jats:title>\n For stable patients with cerebral hemorrhage, CT angiography is recommended before treatment. In surgery of patients with MMD-associated hemorrhage, avoid using artificial dura mater as it can hinder external carotid circulation and complicate future bypass procedures.<\/jats:p>\n \n https:\/\/thejns.org\/doi\/10.3171\/CASE24848<\/jats:ext-link>\n <\/jats:p>\n <\/jats:sec>","DOI":"10.3171\/case24848","type":"journal-article","created":{"date-parts":[[2025,5,5]],"date-time":"2025-05-05T20:14:48Z","timestamp":1746476088000},"source":"Crossref","is-referenced-by-count":0,"title":["Five aneurysms in the posterior circulation associated with moyamoya disease: illustrative case"],"prefix":"10.3171","volume":"9","author":[{"given":"Yao","family":"Anhui","sequence":"first","affiliation":[{"name":"Department of Neurosurgery, The 988th Hospital of PLA, Zhengzhou, Henan Province, China"},{"name":"State Key Laboratory of Explosion Science and Technology, Beijing Institute of Technology, Beijing, China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5675-0052","authenticated-orcid":true,"given":"Liyun","family":"Jia","sequence":"additional","affiliation":[{"name":"School of Basic Medical Sciences, Zhengzhou University, Zhengzhou, Henan Province, China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Wei","family":"Huang","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, The 988th Hospital of PLA, Zhengzhou, Henan Province, China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yu","family":"Fu","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, The 988th Hospital of PLA, Zhengzhou, Henan Province, China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Fuqiang","family":"Cao","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, The 988th Hospital of PLA, Zhengzhou, Henan Province, China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Zhennan","family":"Hou","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, The 988th Hospital of PLA, Zhengzhou, Henan Province, China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Benhan","family":"Wang","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, The 988th Hospital of PLA, Zhengzhou, Henan Province, China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Xiaodong","family":"Guo","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, The 988th Hospital of PLA, Zhengzhou, Henan Province, China"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1754","reference":[{"issue":"3","key":"bib1","series-title":"Arch Neurol","first-page":"288","article-title":"Cerebrovascular \u201cmoyamoya\u201d disease. Disease showing abnormal net-like vessels in base of brain","volume":"20","author":"Suzuki","year":"1969","unstructured":"Suzuki JTakaku A.Cerebrovascular \u201cmoyamoya\u201d disease. Disease showing abnormal net-like vessels in base of brain. Arch Neurol. 1969;20(3):288-299."},{"issue":"1","key":"bib2","series-title":"Stroke","first-page":"104","article-title":"Moyamoya disease\u2014a review","volume":"14","author":"Suzuki","year":"1983","unstructured":"Suzuki JKodama N.Moyamoya disease\u2014a review. Stroke. 1983;14(1):104-109."},{"issue":"5","key":"bib3","series-title":"Int J Stroke","first-page":"542","article-title":"Clinical features of and risk factors for intracranial aneurysms associated with moyamoya disease","volume":"16","author":"Yang","year":"2021","unstructured":"Yang HZhang LWang MWang JChen LLu H.Clinical features of and risk factors for intracranial aneurysms associated with moyamoya disease. Int J Stroke. 2021;16(5):542-550."},{"key":"bib4","series-title":"Front Neurol","article-title":"Natural course and risk factors of moyamoya disease with unruptured intracranial aneurysm","volume":"14","author":"Yang","year":"2023","unstructured":"Yang RMHao FBZhao BNatural course and risk factors of moyamoya disease with unruptured intracranial aneurysm. Front Neurol. 2023;14:1115909."},{"issue":"3","key":"bib5","series-title":"Int J Med Sci","first-page":"234","article-title":"Treatment strategies for aneurysms associated with moyamoya disease","volume":"12","author":"Zhang","year":"2015","unstructured":"Zhang LXu KZhang YWang XYu J.Treatment strategies for aneurysms associated with moyamoya disease. Int J Med Sci. 2015;12(3):234-242."},{"issue":"1","key":"bib6","series-title":"Cureus","first-page":"e52370","article-title":"Radiological features and management of intracranial aneurysms associated with moyamoya disease: a case series of single-center experience","volume":"16","author":"Phuyal","year":"2024","unstructured":"Phuyal SGaikwad SBGarg AJain NNayak MDevarajan LJ.Radiological features and management of intracranial aneurysms associated with moyamoya disease: a case series of single-center experience. Cureus. 2024;16(1):e52370."},{"issue":"9","key":"bib7","series-title":"Neurol Med Chir (Tokyo)","first-page":"824","article-title":"Moyamoya disease: recent progress and outlook","volume":"50","author":"Takahashi","year":"2010","unstructured":"Takahashi JCMiyamoto S.Moyamoya disease: recent progress and outlook. Neurol Med Chir (Tokyo). 2010;50(9):824-832."},{"issue":"suppl 2","key":"bib8","series-title":"Clin Neurol Neurosurg","first-page":"S183","article-title":"The current status of the treatment for hemorrhagic type moyamoya disease based on a 1995 nationwide survey in japan","volume":"99","author":"Ikezaki","year":"1997","unstructured":"Ikezaki KFukui MInamura TKinukawa NWakai KOno Y.The current status of the treatment for hemorrhagic type moyamoya disease based on a 1995 nationwide survey in japan. Clin Neurol Neurosurg. 1997;99(suppl 2):S183-S186."},{"issue":"1","key":"bib9","series-title":"Stroke","first-page":"50","article-title":"Histopathology of the brain vascular network in moyamoya disease","volume":"14","author":"Yamashita","year":"1983","unstructured":"Yamashita MOka KTanaka K.Histopathology of the brain vascular network in moyamoya disease. Stroke. 1983;14(1):50-58."},{"issue":"2","key":"bib10","series-title":"J Neurosurg","first-page":"328","article-title":"Moyamoya disease with repeated intraventricular hemorrhage due to aneurysm rupture. Report of two cases","volume":"80","author":"Hamada","year":"1994","unstructured":"Hamada JHashimoto NTsukahara T.Moyamoya disease with repeated intraventricular hemorrhage due to aneurysm rupture. Report of two cases. J Neurosurg. 1994;80(2):328-331."},{"issue":"6","key":"bib11","series-title":"J Neurosurg","first-page":"1813","article-title":"Treatment of aneurysms in patients with moyamoya disease: a 10-year single-center experience","volume":"128","author":"Ni","year":"2018","unstructured":"Ni WJiang HXu BTreatment of aneurysms in patients with moyamoya disease: a 10-year single-center experience. J Neurosurg. 2018;128(6):1813-1822."},{"issue":"1","key":"bib12","series-title":"Chin Neurosurg J","first-page":"37","article-title":"Classification and treatment strategy for moyamoya disease-related aneurysms","volume":"9","author":"Hu","year":"2023","unstructured":"Hu YWang XLi CClassification and treatment strategy for moyamoya disease-related aneurysms. Chin Neurosurg J. 2023;9(1):37."},{"issue":"18","key":"bib13","series-title":"J Clin Med","first-page":"5951","article-title":"Moyamoya disease: clinical and radiological characteristics in adult Greek patients","volume":"12","author":"Vassilopoulou","year":"2023","unstructured":"Vassilopoulou STountopoulou AKorompoki EMoyamoya disease: clinical and radiological characteristics in adult Greek patients. J Clin Med. 2023;12(18):5951."},{"issue":"3","key":"bib14","series-title":"J Neurosurg","first-page":"637","article-title":"Treatment of ruptured aneurysms of the choroidal collateral system in moyamoya disease: a systematic review and data analysis","volume":"136","author":"Wiedmann","year":"2022","unstructured":"Wiedmann MKHDavidoff CLo Presti ATreatment of ruptured aneurysms of the choroidal collateral system in moyamoya disease: a systematic review and data analysis. J Neurosurg. 2022;136(3):637-646."},{"issue":"1","key":"bib15","series-title":"Neurosurg Rev","first-page":"261","article-title":"The prospects and pitfalls in the endovascular treatment of moyamoya disease-associated intracranial aneurysms","volume":"44","author":"Hou","year":"2021","unstructured":"Hou KLi GLuan TXu KYu J.The prospects and pitfalls in the endovascular treatment of moyamoya disease-associated intracranial aneurysms. Neurosurg Rev. 2021;44(1):261-271."},{"key":"bib16","series-title":"J Clin Neurosci","first-page":"219","article-title":"Pathogenesis of aneurysms on major vessels in moyamoya disease and management outcome","volume":"61","author":"Furtado","year":"2019","unstructured":"Furtado SVMedress ZATeo MSteinberg GK.Pathogenesis of aneurysms on major vessels in moyamoya disease and management outcome. J Clin Neurosci. 2019;61:219-224."},{"issue":"5","key":"bib17","series-title":"Neurosurgery","first-page":"1049","article-title":"High-risk age for rebleeding in patients with hemorrhagic moyamoya disease: long-term follow-up study","volume":"52","author":"Morioka","year":"2003","unstructured":"Morioka MHamada JITodaka TYano SKai YUshio Y.High-risk age for rebleeding in patients with hemorrhagic moyamoya disease: long-term follow-up study. Neurosurgery. 2003;52(5):1049-1054."},{"issue":"11","key":"bib18","series-title":"Acta Neurochir (Wien)","first-page":"1287","article-title":"Characteristics of intracranial aneurysms associated with moyamoya disease. A review of 111 cases","volume":"138","author":"Kawaguchi","year":"1996","unstructured":"Kawaguchi SSakaki TMorimoto TKakizaki TKamada K.Characteristics of intracranial aneurysms associated with moyamoya disease. A review of 111 cases. Acta Neurochir (Wien). 1996;138(11):1287-1294."},{"issue":"3","key":"bib19","series-title":"J Clin Neurosci","first-page":"268","article-title":"Moyamoya disease associated with basilar tip aneurysm","volume":"6","author":"Bhattacharjee","year":"1999","unstructured":"Bhattacharjee AKTamaki NMinami HEhara K.Moyamoya disease associated with basilar tip aneurysm. J Clin Neurosci. 1999;6(3):268-271."},{"issue":"4","key":"bib20","series-title":"Med (Baltim)","first-page":"e32777","article-title":"Safety and effects of endovascular treatment of basilar tip aneurysms in patients with moyamoya diseases","volume":"102","author":"Chen","year":"2023","unstructured":"Chen CGGao BLYang CBSafety and effects of endovascular treatment of basilar tip aneurysms in patients with moyamoya diseases. Med (Baltim). 2023;102(4):e32777."},{"issue":"3","key":"bib1","series-title":"Arch Neurol","first-page":"288","article-title":"Cerebrovascular \u201cmoyamoya\u201d disease. Disease showing abnormal net-like vessels in base of brain","volume":"20","author":"Suzuki","year":"1969","unstructured":"Suzuki JTakaku A.Cerebrovascular \u201cmoyamoya\u201d disease. Disease showing abnormal net-like vessels in base of brain. Arch Neurol. 1969;20(3):288-299."},{"issue":"1","key":"bib2","series-title":"Stroke","first-page":"104","article-title":"Moyamoya disease\u2014a review","volume":"14","author":"Suzuki","year":"1983","unstructured":"Suzuki JKodama N.Moyamoya disease\u2014a review. Stroke. 1983;14(1):104-109."},{"issue":"5","key":"bib3","series-title":"Int J Stroke","first-page":"542","article-title":"Clinical features of and risk factors for intracranial aneurysms associated with moyamoya disease","volume":"16","author":"Yang","year":"2021","unstructured":"Yang HZhang LWang MWang JChen LLu H.Clinical features of and risk factors for intracranial aneurysms associated with moyamoya disease. Int J Stroke. 2021;16(5):542-550."},{"key":"bib4","series-title":"Front Neurol","article-title":"Natural course and risk factors of moyamoya disease with unruptured intracranial aneurysm","volume":"14","author":"Yang","year":"2023","unstructured":"Yang RMHao FBZhao BNatural course and risk factors of moyamoya disease with unruptured intracranial aneurysm. Front Neurol. 2023;14:1115909."},{"issue":"3","key":"bib5","series-title":"Int J Med Sci","first-page":"234","article-title":"Treatment strategies for aneurysms associated with moyamoya disease","volume":"12","author":"Zhang","year":"2015","unstructured":"Zhang LXu KZhang YWang XYu J.Treatment strategies for aneurysms associated with moyamoya disease. Int J Med Sci. 2015;12(3):234-242."},{"issue":"1","key":"bib6","series-title":"Cureus","first-page":"e52370","article-title":"Radiological features and management of intracranial aneurysms associated with moyamoya disease: a case series of single-center experience","volume":"16","author":"Phuyal","year":"2024","unstructured":"Phuyal SGaikwad SBGarg AJain NNayak MDevarajan LJ.Radiological features and management of intracranial aneurysms associated with moyamoya disease: a case series of single-center experience. Cureus. 2024;16(1):e52370."},{"issue":"9","key":"bib7","series-title":"Neurol Med Chir (Tokyo)","first-page":"824","article-title":"Moyamoya disease: recent progress and outlook","volume":"50","author":"Takahashi","year":"2010","unstructured":"Takahashi JCMiyamoto S.Moyamoya disease: recent progress and outlook. Neurol Med Chir (Tokyo). 2010;50(9):824-832."},{"issue":"suppl 2","key":"bib8","series-title":"Clin Neurol Neurosurg","first-page":"S183","article-title":"The current status of the treatment for hemorrhagic type moyamoya disease based on a 1995 nationwide survey in japan","volume":"99","author":"Ikezaki","year":"1997","unstructured":"Ikezaki KFukui MInamura TKinukawa NWakai KOno Y.The current status of the treatment for hemorrhagic type moyamoya disease based on a 1995 nationwide survey in japan. Clin Neurol Neurosurg. 1997;99(suppl 2):S183-S186."},{"issue":"1","key":"bib9","series-title":"Stroke","first-page":"50","article-title":"Histopathology of the brain vascular network in moyamoya disease","volume":"14","author":"Yamashita","year":"1983","unstructured":"Yamashita MOka KTanaka K.Histopathology of the brain vascular network in moyamoya disease. Stroke. 1983;14(1):50-58."},{"issue":"2","key":"bib10","series-title":"J Neurosurg","first-page":"328","article-title":"Moyamoya disease with repeated intraventricular hemorrhage due to aneurysm rupture. Report of two cases","volume":"80","author":"Hamada","year":"1994","unstructured":"Hamada JHashimoto NTsukahara T.Moyamoya disease with repeated intraventricular hemorrhage due to aneurysm rupture. Report of two cases. J Neurosurg. 1994;80(2):328-331."},{"issue":"6","key":"bib11","series-title":"J Neurosurg","first-page":"1813","article-title":"Treatment of aneurysms in patients with moyamoya disease: a 10-year single-center experience","volume":"128","author":"Ni","year":"2018","unstructured":"Ni WJiang HXu BTreatment of aneurysms in patients with moyamoya disease: a 10-year single-center experience. J Neurosurg. 2018;128(6):1813-1822."},{"issue":"1","key":"bib12","series-title":"Chin Neurosurg J","first-page":"37","article-title":"Classification and treatment strategy for moyamoya disease-related aneurysms","volume":"9","author":"Hu","year":"2023","unstructured":"Hu YWang XLi CClassification and treatment strategy for moyamoya disease-related aneurysms. Chin Neurosurg J. 2023;9(1):37."},{"issue":"18","key":"bib13","series-title":"J Clin Med","first-page":"5951","article-title":"Moyamoya disease: clinical and radiological characteristics in adult Greek patients","volume":"12","author":"Vassilopoulou","year":"2023","unstructured":"Vassilopoulou STountopoulou AKorompoki EMoyamoya disease: clinical and radiological characteristics in adult Greek patients. J Clin Med. 2023;12(18):5951."},{"issue":"3","key":"bib14","series-title":"J Neurosurg","first-page":"637","article-title":"Treatment of ruptured aneurysms of the choroidal collateral system in moyamoya disease: a systematic review and data analysis","volume":"136","author":"Wiedmann","year":"2022","unstructured":"Wiedmann MKHDavidoff CLo Presti ATreatment of ruptured aneurysms of the choroidal collateral system in moyamoya disease: a systematic review and data analysis. J Neurosurg. 2022;136(3):637-646."},{"issue":"1","key":"bib15","series-title":"Neurosurg Rev","first-page":"261","article-title":"The prospects and pitfalls in the endovascular treatment of moyamoya disease-associated intracranial aneurysms","volume":"44","author":"Hou","year":"2021","unstructured":"Hou KLi GLuan TXu KYu J.The prospects and pitfalls in the endovascular treatment of moyamoya disease-associated intracranial aneurysms. Neurosurg Rev. 2021;44(1):261-271."},{"key":"bib16","series-title":"J Clin Neurosci","first-page":"219","article-title":"Pathogenesis of aneurysms on major vessels in moyamoya disease and management outcome","volume":"61","author":"Furtado","year":"2019","unstructured":"Furtado SVMedress ZATeo MSteinberg GK.Pathogenesis of aneurysms on major vessels in moyamoya disease and management outcome. J Clin Neurosci. 2019;61:219-224."},{"issue":"5","key":"bib17","series-title":"Neurosurgery","first-page":"1049","article-title":"High-risk age for rebleeding in patients with hemorrhagic moyamoya disease: long-term follow-up study","volume":"52","author":"Morioka","year":"2003","unstructured":"Morioka MHamada JITodaka TYano SKai YUshio Y.High-risk age for rebleeding in patients with hemorrhagic moyamoya disease: long-term follow-up study. Neurosurgery. 2003;52(5):1049-1054."},{"issue":"11","key":"bib18","series-title":"Acta Neurochir (Wien)","first-page":"1287","article-title":"Characteristics of intracranial aneurysms associated with moyamoya disease. A review of 111 cases","volume":"138","author":"Kawaguchi","year":"1996","unstructured":"Kawaguchi SSakaki TMorimoto TKakizaki TKamada K.Characteristics of intracranial aneurysms associated with moyamoya disease. A review of 111 cases. Acta Neurochir (Wien). 1996;138(11):1287-1294."},{"issue":"3","key":"bib19","series-title":"J Clin Neurosci","first-page":"268","article-title":"Moyamoya disease associated with basilar tip aneurysm","volume":"6","author":"Bhattacharjee","year":"1999","unstructured":"Bhattacharjee AKTamaki NMinami HEhara K.Moyamoya disease associated with basilar tip aneurysm. 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