{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,15]],"date-time":"2026-09-15T10:49:04Z","timestamp":1789469344691,"version":"build-2803163510"},"reference-count":20,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2024,11,20]],"date-time":"2024-11-20T00:00:00Z","timestamp":1732060800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Neurol."],"abstract":"<jats:sec><jats:title>Objective<\/jats:title><jats:p>We previously developed the use of side to side (s-s) bypass for the treatment of adult moyamoya disease (MMD) and discovered several kinds of distinct blood flow models intraoperatively, which we observed through indocyanine green-video angiography (ICG-VA). The purpose of this paper was to investigate the correlation between blood flow model (BFM) identified in s-s bypass and the incidence of postoperative cerebral hyperperfusion syndrome (CHS) among patients with MMD.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>We analyzed 166 hemispheres from 153 patients diagnosed with MMD, including 118 hemispheres with s-s bypass and 48 with end to side (e-s) bypass. We categorized the enrolled patients into three pairs of comparison groups based on postoperative CHS (CHS or non-CHS) in s-s bypass, blood flow models (BFM I or BFM II) and surgical approach (s-s bypass or e-s bypass). Patients\u2019 demographics and characteristics were compared between groups.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Among patients who developed CHS, the occurrence of BFM I was more frequent than that of BFM II (0.154 vs. 0.019, <jats:italic>p<\/jats:italic> =\u20090.029\u2009&amp;lt;\u20090.05) and no significant differences were noted in the remaining data. In the group of blood flow models, the proportion of patients with a history of cerebral hemorrhage was higher in BFM II compared to BFM I (0.062 vs. 0.226, <jats:italic>p<\/jats:italic> =\u20090.009\u2009&amp;lt;\u20090.05), and the incidence of severity of ischemia was found to be higher in BFM I than in BFM II (0.774 vs. 0.429, <jats:italic>p<\/jats:italic>\u2009=\u20090.011\u2009&amp;lt;\u20090.05), while the postoperative modified Rankin Scale (mRS) score and the Matsushima grade displayed no obvious difference. In comparison with the occurrence of CHS in e-s bypass group (7\/48, 0.146), s-s bypass group had no difference (11\/118, 0.093; <jats:italic>p<\/jats:italic> =\u20090.323\u2009&amp;gt;\u20090.05), BFM I group showed no discrepancy (10\/65, 0.154, <jats:italic>p<\/jats:italic> =\u20090.906\u2009&amp;gt;\u20090.05) while BFM II group was different (1\/53, 0.019, <jats:italic>p<\/jats:italic> =\u20090.047\u2009&amp;lt;\u20090.05).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>The proportion of postoperative CHS occurring in BFM II during s-s bypass was lower than that in e-s bypass and BFM I. The postbypass blood flow model in s-s bypass may serve as a novel predictor for postoperative CHS.<\/jats:p><\/jats:sec>","DOI":"10.3389\/fneur.2024.1484224","type":"journal-article","created":{"date-parts":[[2024,11,20]],"date-time":"2024-11-20T06:30:19Z","timestamp":1732084219000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":3,"title":["The significance of postbypass blood flow model in side to side bypass for moyamoya disease in predicting postoperative cerebral hyperperfusion syndrome"],"prefix":"10.3389","volume":"15","author":[{"given":"Guiping","family":"Wan","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Miao","family":"Hu","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jin","family":"Yu","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Can","family":"Xin","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tianshu","family":"Tao","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Wei","family":"Quan","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jincao","family":"Chen","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jianjian","family":"Zhang","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1965","published-online":{"date-parts":[[2024,11,20]]},"reference":[{"key":"ref1","doi-asserted-by":"publisher","first-page":"292","DOI":"10.2174\/1570159x19666210716114016","article-title":"Progression 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