Related Experiment Video
Updated: Jul 10, 2026
Transient Middle Cerebral Artery Occlusion Model of Neonatal Stroke in P10 Rats
Published on: April 21, 2017
Postoperative temporary neurological deficits in adults with moyamoya disease
Shiro Ohue1, Yoshiaki Kumon, Kanehisa Kohno
1Department of Neurosurgery, Ehime University School of Medicine, Ehime 791-0295, Japan. sohue@m.ehime-u.ac.jp
Background:
Several authors have reported temporary neurologic deterioration after revascularization surgery in some patients with moyamoya disease. The present study examined the incidence and mechanisms of PONDs in adult patients with moyamoya disease.
Methods:
Postoperative neurological deficits were retrospectively evaluated 1 month or less postoperatively on 32 hemispheric sides of 17 symptomatic adult patients with moyamoya disease treated surgically with direct and/or indirect revascularization.
Results:
Various PONDs were observed in 9 sides (28%) from 7 patients 1 month or less after surgery. Symptoms were recognized in 7 (39%) of 18 sides with ischemic onset, and 2 (14%) of 14 sides with hemorrhagic onset. Postoperative neurological deficits were usually observed 1 week or less after surgery, and resolved within 2 weeks. Postoperative neurological deficits were divided into 3 groups based on duration of symptoms: single transient neurologic deficits in 3 sides; repeated transient neurologic deficits in 3 sides; and continuous neurologic deficits in 3 sides. Radiologic examinations demonstrated no ischemic changes in any patients, and subsequent focal hyperemia after surgery on 3 sides. Postoperative neurological deficits occurred more frequently in younger patients or those with poor vascular response before surgery.
Conclusions:
Postoperative neurological deficits frequently occur in patients with moyamoya disease, but are temporary. These deficits appear to result from focal hyperperfusion after surgery, rather than from ischemic changes.
Insights
Temporary neurologic deficits after revascularization surgery are common in moyamoya disease patients. These postoperative neurological deficits (PONDs) usually resolve within two weeks and appear linked to focal hyperperfusion, not ischemia.
Area of Science:
- Neurosurgery
- Neurology
- Vascular Surgery
Background:
- Moyamoya disease revascularization surgery can lead to temporary neurologic deterioration.
- The incidence and mechanisms of postoperative neurological deficits (PONDs) in adult moyamoya disease patients require further investigation.
Purpose of the Study:
- To determine the incidence and mechanisms of temporary neurologic deterioration following revascularization surgery in adult moyamoya disease patients.
Main Methods:
- Retrospective evaluation of 32 hemispheric sides from 17 adult moyamoya disease patients undergoing direct and/or indirect revascularization.
- Assessment of postoperative neurological deficits within one month of surgery.
Main Results:
- Postoperative neurological deficits (PONDs) occurred in 28% of cases, typically within one week and resolving within two weeks.
- Deficits were more common in patients with ischemic onset (39%) compared to hemorrhagic onset (14%).
- No ischemic changes were detected radiologically; focal hyperemia was observed in some cases.
Conclusions:
- Postoperative neurological deficits are frequent but temporary in moyamoya disease patients after revascularization.
- These deficits are likely caused by focal hyperperfusion rather than ischemic events.
- Younger patients or those with poor pre-operative vascular response may be at higher risk.
