[Study of adult cases of moyamoya disease]

Fifty-one adult patients with moyamoya disease were studied. Among these, thirteen cases, which had the history of cerebral ischemic attack during childhood, are classified as the cases of juvenile onset. The other thirty-eight cases were classified as those of adult onset. In most of the cases of juvenile onset, occlusive lesions also affected cortical arteries. For these cases, it is important to perform STA-MCA double anastomoses and encephalo-myo-synangiosis. Those of adult onset resembled the pathophysiology of internal carotid artery occlusion, or that of middle cerebral artery occlusion, since few cortical artery occlusion was noted, and leptomeningeal anastomosis was well developed. STA-MCA anastomosis was considered to be the treatment of choice in those of adult onset.