Providence Moyamoya Center
Resources to Heal a Rare Disease
Providence Moyamoya Center offers hope for people with a rare disease that affects blood vessels in the brain. The center has the right combination of resources – highly skilled specialists and advanced technology – to help people with this rare disease.
Doctors at Providence Moyamoya Center are specialists. They evaluate each patient and create a treatment plan specifically designed for that person’s needs. They use evidence-based methods and state-of-the-art technologies. Each patient receives high-level care in a supportive, compassionate environment.
Moyamoya disease causes major blood vessels at the base of the brain to become progressively narrower and more blocked. To compensate for the blockages in the large blood vessels, tangles of tiny vessels form to help deliver blood to the brain. On imaging scans, these tiny vessels appear light and wispy. This appearance led to the name “moyamoya,” which in Japanese means “puff of smoke.”
People with this condition are at an ever-increasing risk of strokes or mini-strokes (TIAs). They may also have muscle weakness or paralysis on one side of the body, or they may have seizures.
Medicine alone can’t prevent the disease from progressing. Almost two-thirds of patients with Moyamoya disease develop increasing symptoms over five years. Early diagnosis and appropriate treatment are very important. Surgery can restore blood flow to the brain by opening narrowed blood vessels or by creating bypasses around blockages. After surgery, most people experience no more strokes or related problems.
Moyamoya was first described in the 1960s. At that time, it was thought to affect mainly people of Asian heritage. It has now been recorded in people of many ethnic backgrounds, including those of African, American and European heritage. Moyamoya is seen most commonly in children, but it can also occur in adults in their mid-40s. Females have it nearly twice as often as males. The condition tends to run in families.
People affected by Moyamoya disease may experience these symptoms:
- Ischemic stroke (sustained weakness, numbness in arms and legs, difficulty with speech and vision)
- TIA (mini-stroke, short attacks of weakness, numbness or difficulty with speech)
- Hemorrhage (bleeding in the brain due to the rupture of fragile, diseased blood vessels)
- Headaches
- Seizures
- Worsening cognitive or psychiatric changes if the disease is not appropriately treated
Several different surgeries can be used to treat Moyamoya disease. These surgeries create detours around the damaged blood vessels and restore blood flow to the brain. By improving the blood flow, we can help prevent ministrokes, strokes and bleeding.
Our surgeons have advanced skills in microsurgery. They have a high rate of success in all performing all types of cerebral bypass surgeries.
The direct bypass method, called an extracranial-tointracranial bypass, improves blood flow immediately. It is the preferred method, and it is the one that our surgeons use most frequently for Moyamoya disease.
The scalp vessel known as the superficial temporal artery (STA) is redirected and sutured using fine sutures to a blood vessel on the surface of the brain. This immediately improves blood flow to the part of the brain that is chronically deprived of oxygen in Moyamoya patients.
When direct bypass is not an option, surgeons may perform one of three types of indirect bypass grafts. For patients who face higher risks with direct bypass and for those who may not have a suitable graft available, the indirect methods are good options.
An “onlay” procedure where the superficial temporal artery (STA) is placed on the surface of the brain may be the best option for providing additional blood flow. New vessels sprout off the STA into the surrounding brain. Blood vessels also grow from the reflected dura into the brain in order to provide more oxygen. This process of new blood vessel growth usually matures about 6 months after surgery.
The surgical exposure includes both the frontal and temporal lobes. The fissure between the two lobes carries the majority of the blood vessels that provide oxygen to this region of the brain.
These arteries are exposed during surgery and the scalp artery known as the superficial temporal artery (STA) is exposed as well in order to prepare for the bypass procedure.
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The Providence Brain and Spine Institute is a comprehensive, integrated center of excellence that treats all conditions of the brain and spine. We are the leading provider of neurological care in Oregon committed to making a positive difference in every life we touch. Our patients are at the center of everything we do. See a complete list of conditions we treat and learn more about the care we offer.