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Moyamoya phenomenon

MedGen UID:
868764
Concept ID:
C4023169
Disease or Syndrome
HPO: HP:0011834

Definition

A noninflammatory, progressive occlusion of the intracranial carotid arteries owing to the formation of netlike collateral arteries arising from the circle of Willis. [from HPO]

Conditions with this feature

Microcephalic osteodysplastic primordial dwarfism type II
MedGen UID:
96587
Concept ID:
C0432246
Disease or Syndrome
Microcephalic osteodysplastic primordial dwarfism type II (MOPDII), the most common form of microcephalic primordial dwarfism, is characterized by extreme short stature and microcephaly along with distinctive facial features. Associated features that differentiate it from other forms of primordial dwarfism and that may necessitate treatment include: abnormal dentition, a slender bone skeletal dysplasia with hip deformity and/or scoliosis, insulin resistance / diabetes mellitus, chronic kidney disease, cardiac malformations, and global vascular disease. The latter includes neurovascular disease such as moyamoya vasculopathy and intracranial aneurysms (which can lead to strokes), coronary artery disease (which can lead to premature myocardial infarctions), and renal vascular disease. Hypertension, which is also common, can have multiple underlying causes given the complex comorbidities.
Moyamoya disease 2
MedGen UID:
339584
Concept ID:
C1846689
Disease or Syndrome
Moyamoya disease is a progressive cerebral angiopathy characterized by bilateral internal carotid artery stenosis and abnormal collateral vessels. The abnormal vessels resemble a 'puff of smoke' (moyamoya) on cerebral angiogram. Affected individuals can develop transient ischemic attacks and/or cerebral infarction, and rupture of the collateral vessels can cause intracranial hemorrhage (summary by Kamada et al., 2011). For a general phenotypic description and a discussion of genetic heterogeneity of moyamoya disease, see MYMY1 (252350).
Aortic aneurysm, familial thoracic 6
MedGen UID:
435866
Concept ID:
C2673186
Disease or Syndrome
Any familial thoracic aortic aneurysm and aortic dissection in which the cause of the disease is a mutation in the ACTA2 gene.
Moyamoya angiopathy-short stature-facial dysmorphism-hypergonadotropic hypogonadism syndrome
MedGen UID:
463207
Concept ID:
C3151857
Disease or Syndrome
This multisystem disorder is characterized by moyamoya disease, short stature, hypergonadotropic hypogonadism, and facial dysmorphism. Other variable features include dilated cardiomyopathy, premature graying of the hair, and early-onset cataracts. Moyamoya disease is a progressive cerebrovascular disorder characterized by stenosis or occlusion of the internal carotid arteries and the main branches, leading to the development of small collateral vessels (moyamoya vessels) at the base of the brain. Affected individuals can develop acute neurologic events due to stroke-like episodes (summary by Miskinyte et al., 2011). For a general phenotypic description and a discussion of genetic heterogeneity of moyamoya disease, see MYMY1 (252350).
Moyamoya disease 5
MedGen UID:
481320
Concept ID:
C3279690
Disease or Syndrome
Moyamoya disease is a cerebrovascular disorder caused by stenotic changes of terminal portions of the internal carotid arteries accompanied by surrounding fine arterial collateral vessels. These vascular networks resemble a 'puff of smoke' (Japanese: moyamoya) in angiographic imaging (summary by Roder et al., 2011). For a general phenotypic description and a discussion of genetic heterogeneity of moyamoya disease, see MYMY1 (252350).
Moyamoya disease with early-onset achalasia
MedGen UID:
816733
Concept ID:
C3810403
Disease or Syndrome
Moyamoya disease-6 is a progressive vasculopathy characterized by occlusion of the terminal portion of the internal carotid arteries and its branches, and the formation of compensatory neovascularization and the moyamoya, or 'puff of smoke,' appearance of these vessels on angiogram. Affected individuals may present with ischemic strokes, intracerebral hemorrhage, or transient ischemic attacks. Patients with MYMY6 usually present early in life with achalasia. Hypertension and Raynaud phenomenon may be associated features (summary by Wallace et al., 2016; Herve et al., 2014). For a general phenotypic description and a discussion of genetic heterogeneity of moyamoya disease, see MYMY1 (252350).

Professional guidelines

PubMed

Velo M, Grasso G, Fujimura M, Torregrossa F, Longo M, Granata F, Pitrone A, Vinci SL, Ferraù L, La Spina P
World Neurosurg 2022 Mar;159:409-425. doi: 10.1016/j.wneu.2021.11.026. PMID: 35255640
Arias EJ, Derdeyn CP, Dacey RG Jr, Zipfel GJ
Neurosurgery 2014 Feb;74 Suppl 1:S116-25. doi: 10.1227/NEU.0000000000000229. PMID: 24402480

Recent clinical studies

Etiology

Derdeyn CP
J Cereb Blood Flow Metab 2018 Sep;38(9):1584-1597. Epub 2017 Sep 19 doi: 10.1177/0271678X17732884. PMID: 28925313Free PMC Article
Derdeyn CP, Zipfel GJ, Zazulia AR, Davis PH, Prabhakaran S, Ivan CS, Aiyagari V, Sagar JR, Hantler N, Shinawi L, Lee JJ, Jafri H, Grubb RL Jr, Miller JP, Dacey RG Jr
Stroke 2017 Apr;48(4):894-899. Epub 2017 Mar 10 doi: 10.1161/STROKEAHA.116.014538. PMID: 28283605Free PMC Article
Arias EJ, Dunn GP, Washington CW, Derdeyn CP, Chicoine MR, Grubb RL Jr, Moran CJ, Cross DT 3rd, Dacey RG Jr, Zipfel GJ
J Stroke Cerebrovasc Dis 2015 Jul;24(7):1597-608. Epub 2015 May 9 doi: 10.1016/j.jstrokecerebrovasdis.2015.03.053. PMID: 25972283Free PMC Article
Hallemeier CL, Rich KM, Grubb RL Jr, Chicoine MR, Moran CJ, Cross DT 3rd, Zipfel GJ, Dacey RG Jr, Derdeyn CP
Stroke 2006 Jun;37(6):1490-6. Epub 2006 Apr 27 doi: 10.1161/01.STR.0000221787.70503.ca. PMID: 16645133
Kestle JR, Hoffman HJ, Mock AR
J Neurosurg 1993 Jul;79(1):32-5. doi: 10.3171/jns.1993.79.1.0032. PMID: 8315466

Diagnosis

Komiyama M
Interv Neuroradiol 2017 Dec;23(6):572-576. Epub 2017 Aug 16 doi: 10.1177/1591019917726093. PMID: 28814167Free PMC Article
Arias EJ, Dunn GP, Washington CW, Derdeyn CP, Chicoine MR, Grubb RL Jr, Moran CJ, Cross DT 3rd, Dacey RG Jr, Zipfel GJ
J Stroke Cerebrovasc Dis 2015 Jul;24(7):1597-608. Epub 2015 May 9 doi: 10.1016/j.jstrokecerebrovasdis.2015.03.053. PMID: 25972283Free PMC Article
Hallemeier CL, Rich KM, Grubb RL Jr, Chicoine MR, Moran CJ, Cross DT 3rd, Zipfel GJ, Dacey RG Jr, Derdeyn CP
Stroke 2006 Jun;37(6):1490-6. Epub 2006 Apr 27 doi: 10.1161/01.STR.0000221787.70503.ca. PMID: 16645133
Fodstad H, Bodosi M, Forssell A, Perricone D
Br J Neurosurg 1996 Apr;10(2):179-86. doi: 10.1080/02688699650040340. PMID: 8861310
Kestle JR, Hoffman HJ, Mock AR
J Neurosurg 1993 Jul;79(1):32-5. doi: 10.3171/jns.1993.79.1.0032. PMID: 8315466

Therapy

Derdeyn CP, Zipfel GJ, Zazulia AR, Davis PH, Prabhakaran S, Ivan CS, Aiyagari V, Sagar JR, Hantler N, Shinawi L, Lee JJ, Jafri H, Grubb RL Jr, Miller JP, Dacey RG Jr
Stroke 2017 Apr;48(4):894-899. Epub 2017 Mar 10 doi: 10.1161/STROKEAHA.116.014538. PMID: 28283605Free PMC Article
Arias EJ, Dunn GP, Washington CW, Derdeyn CP, Chicoine MR, Grubb RL Jr, Moran CJ, Cross DT 3rd, Dacey RG Jr, Zipfel GJ
J Stroke Cerebrovasc Dis 2015 Jul;24(7):1597-608. Epub 2015 May 9 doi: 10.1016/j.jstrokecerebrovasdis.2015.03.053. PMID: 25972283Free PMC Article
Mok CC, Poon WL
Rheumatology (Oxford) 2011 Oct;50(10):1931. Epub 2011 Jul 13 doi: 10.1093/rheumatology/ker248. PMID: 21752869
Zipfel GJ, Sagar J, Miller JP, Videen TO, Grubb RL Jr, Dacey RG Jr, Derdeyn CP
Neurosurg Focus 2009 Apr;26(4):E6. doi: 10.3171/2009.01.FOCUS08305. PMID: 19335132Free PMC Article
Kornblihtt LI, Cocorullo S, Miranda C, Lylyk P, Heller PG, Molinas FC
Stroke 2005 Aug;36(8):E71-3. Epub 2005 Jul 14 doi: 10.1161/01.STR.0000174193.89864.55. PMID: 16020757

Prognosis

Lee JJ, Shimony JS, Jafri H, Zazulia AR, Dacey RG Jr, Zipfel GR, Derdeyn CP
AJNR Am J Neuroradiol 2018 Nov;39(11):2037-2044. Epub 2018 Oct 25 doi: 10.3174/ajnr.A5812. PMID: 30361434Free PMC Article
Derdeyn CP
J Cereb Blood Flow Metab 2018 Sep;38(9):1584-1597. Epub 2017 Sep 19 doi: 10.1177/0271678X17732884. PMID: 28925313Free PMC Article
Derdeyn CP, Zipfel GJ, Zazulia AR, Davis PH, Prabhakaran S, Ivan CS, Aiyagari V, Sagar JR, Hantler N, Shinawi L, Lee JJ, Jafri H, Grubb RL Jr, Miller JP, Dacey RG Jr
Stroke 2017 Apr;48(4):894-899. Epub 2017 Mar 10 doi: 10.1161/STROKEAHA.116.014538. PMID: 28283605Free PMC Article
Arias EJ, Dunn GP, Washington CW, Derdeyn CP, Chicoine MR, Grubb RL Jr, Moran CJ, Cross DT 3rd, Dacey RG Jr, Zipfel GJ
J Stroke Cerebrovasc Dis 2015 Jul;24(7):1597-608. Epub 2015 May 9 doi: 10.1016/j.jstrokecerebrovasdis.2015.03.053. PMID: 25972283Free PMC Article
Hallemeier CL, Rich KM, Grubb RL Jr, Chicoine MR, Moran CJ, Cross DT 3rd, Zipfel GJ, Dacey RG Jr, Derdeyn CP
Stroke 2006 Jun;37(6):1490-6. Epub 2006 Apr 27 doi: 10.1161/01.STR.0000221787.70503.ca. PMID: 16645133

Clinical prediction guides

Lee JJ, Shimony JS, Jafri H, Zazulia AR, Dacey RG Jr, Zipfel GR, Derdeyn CP
AJNR Am J Neuroradiol 2018 Nov;39(11):2037-2044. Epub 2018 Oct 25 doi: 10.3174/ajnr.A5812. PMID: 30361434Free PMC Article
Doctor PN, Choudhari A, Verma M, Merchant RH
J Postgrad Med 2018 Oct-Dec;64(4):240-242. doi: 10.4103/jpgm.JPGM_468_17. PMID: 29943740Free PMC Article
Derdeyn CP
J Cereb Blood Flow Metab 2018 Sep;38(9):1584-1597. Epub 2017 Sep 19 doi: 10.1177/0271678X17732884. PMID: 28925313Free PMC Article
Arias EJ, Dunn GP, Washington CW, Derdeyn CP, Chicoine MR, Grubb RL Jr, Moran CJ, Cross DT 3rd, Dacey RG Jr, Zipfel GJ
J Stroke Cerebrovasc Dis 2015 Jul;24(7):1597-608. Epub 2015 May 9 doi: 10.1016/j.jstrokecerebrovasdis.2015.03.053. PMID: 25972283Free PMC Article
Starke RM, Komotar RJ, Hickman ZL, Paz YE, Pugliese AG, Otten ML, Garrett MC, Elkind MS, Marshall RS, Festa JR, Meyers PM, Connolly ES Jr
J Neurosurg 2009 Nov;111(5):936-42. doi: 10.3171/2009.3.JNS08837. PMID: 19374496Free PMC Article

Recent systematic reviews

Sudhir BJ, Keelara AG, Venkat EH, Kazumata K, Sundararaman A
Neurosurg Focus 2021 Sep;51(3):E6. doi: 10.3171/2021.6.FOCUS21281. PMID: 34469862

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