Understanding Moyamoya Disease & Expert Treatment in LA

Moyamoya disease remains one of medicine's most challenging cerebrovascular disorders. This condition progressively narrows and ultimately blocks the main arteries that supply blood to the brain, forcing the body to develop small, fragile blood vessels as a workaround. 

For children and middle-aged adults who make up the majority of patients, the stakes are particularly high, as untreated Moyamoya significantly increases stroke risk and can lead to permanent neurological damage. 

Read on to explore the symptoms that signal this complex condition, learn its causes, and discover how it is diagnosed and treated by the best moyamoya surgeon in Los Angeles. 

What Is Moyamoya Disease?

Moyamoya disease is a chronic, progressive condition that affects the blood supply to the brain. It occurs when the internal carotid arteries, which are the major blood vessels that deliver oxygen-rich blood to the brain, gradually narrow and eventually become blocked. 

As the body tries to compensate for this reduced blood flow, tiny new blood vessels form around the blockage. These small, fragile vessels create a hazy, cloud-like appearance on brain imaging, which Japanese doctors have named moyamoya, meaning puff of smoke. The reduced blood flow to the brain creates a constant risk, as the brain's cells require a continuous supply of oxygen to function correctly.

Without proper treatment, this condition can cause serious complications, including:

• Strokes
• Transient ischemic attacks (TIAs), also called mini-strokes
• Seizures
• Cognitive or developmental delays in children 

What Causes Moyamoya Disease?

The exact cause of Moyamoya disease remains a medical mystery, though researchers have uncovered important clues. There appears to be a significant genetic component, especially among East Asian populations where the condition is most common and often runs in families. 

Moyamoya disease appears in two forms: a primary disease that develops without any known trigger, and secondary moyamoya, also known as moyamoya syndrome, which evolves due to other underlying conditions. This syndrome form is frequently associated with disorders like Down syndrome, sickle cell disease, neurofibromatosis type 1, and previous radiation therapy to the head. 

Making this distinction between primary disease and secondary syndrome is crucial for effective treatment planning, as addressing any underlying condition may be a vital part of the overall care strategy.

What Are the Symptoms of Moyamoya Disease?

Moyamoya disease typically presents with a range of concerning symptoms that can vary by age. Common warning signs include: 

• Stroke-like episodes
• Persistent headaches, often triggered by hyperventilation or exercise
• Seizures
• Weakness or numbness on one side of the body
• Difficulty speaking
• Visual disturbances

Children with Moyamoya frequently experience transient ischemic attacks (TIAs) or actual strokes, which may cause them to collapse, develop paralysis, or have trouble speaking suddenly. Adults, on the other hand, are more likely to experience brain hemorrhages in addition to these symptoms, resulting in sudden, severe headaches and altered consciousness. 

What makes Moyamoya particularly dangerous is its progressive nature. Without proper treatment, symptoms typically worsen over time as blood vessels continue to narrow, reducing blood flow to critical brain regions and increasing the risk of permanent brain damage with each episode.

How Is Moyamoya Disease Diagnosed?

Diagnosing Moyamoya disease usually requires advanced brain imaging to visualize the characteristic abnormalities in blood vessels. Sometimes, an early diagnosis begins when a patient experiences recurrent unexplained strokes or mini-strokes, especially in younger individuals, where such events are unusual. 

Doctors often use a combination of imaging techniques to confirm the diagnosis, starting with magnetic resonance imaging (MRI) to check for evidence of past strokes and magnetic resonance angiography (MRA) to examine the structure of blood vessels. 

Another way to diagnose this condition is with a cerebral angiography, an invasive procedure in which contrast dye is injected into the blood vessels, revealing the distinctive pattern of tiny collateral blood vessels that attempt to bypass the narrowed arteries. 

What Are the Treatment Options for Moyamoya Disease in Los Angeles?

The primary and most effective treatment for Moyamoya disease is surgical revascularization — procedures designed to restore healthy blood flow to the brain. While medications such as aspirin or other blood thinners may be prescribed to reduce stroke risk by preventing blood clots, these medicines only manage symptoms and cannot stop the disease's progression. Surgery offers the only long-term protection against future strokes. 

Cerebral Bypass Surgery in Los Angeles for Moyamoya Disease

Cerebral bypass surgery serves as a lifeline for Moyamoya patients by creating alternative pathways for blood to reach oxygen-starved brain tissue. This critical procedure creates a detour around the blocked internal carotid arteries, restoring vital blood flow and significantly reducing the risk of stroke. 

Neurosurgeons can do this in two ways: 

• Direct bypass: Where neurosurgeons connect a healthy scalp artery,  typically the superficial temporal artery, directly to a brain artery for immediate improved circulation.
• Indirect bypass: Where neurosurgeons lay donor blood vessels on the brain's surface, allowing new vessels to grow into the brain over several months. 

Each approach has specific advantages depending on the patient's age and condition. 

With timely treatment, many patients experience significantly reduced stroke risk and can lead normal, active lives despite having this rare condition.

Where to Find the Best Moyamoya Surgeon in Los Angeles

When facing a diagnosis as rare and complex as Moyamoya disease, finding the right surgeon can make all the difference. At California Neurosurgical Specialists, we offer patients the expertise of Dr. Arnau Benet, a leading cerebrovascular neurosurgeon known for his precision, innovation, and calm command of high-stakes procedures. 

Our team is deeply experienced in both microsurgical and minimally invasive revascularization techniques, allowing us to tailor each treatment to the patient’s unique anatomy and goals. 

Ready to get the clarity, compassion, and surgical excellence you deserve from the best moyamoya surgeon in Los Angeles?