Revascularization surgery for moyamoya disease

Moyamoya disease is a disease characterized by chronic occlusion of the circle of Willis with subsequent development of fine vascular networks in the ganglionic region, which is common in Japanese people. The term of 'moyamoya' means puff of smoke in the Japanese language and represents the characteristic angiographic findings of subsequent development of fine vascular networks in the ganglionic region. Although reconstructive surgery for moyamoya disease has been widely accepted nowadays, there is still no definite consensus as to a surgical indication for patients with an haemorrhagic attack and as to the selection of an operative method for each individual patient. This paper presents our overall surgical results and introduces a new operation, devised by Y. Nakagawa (i.e. EMAS). It refers also to surgical intervention for patients with haemorrhagic attacks.