Neuroplastic and Augmented Reality Integration in Moyamoya Revascularization: A Reconstructive Microsurgical Paradigm

Cerebrovascular revascularization for moyamoya disease remains one of the most technically demanding procedures in neurosurgery, requiring meticulous microvascular anastomosis and precise intraoperative execution. The success of these operations depends on advanced microsurgical skill, careful teamwork, and refined perioperative planning. This review outlines the emerging neuroplastic approach-a collaborative model between neurosurgeons and plastic microsurgeons-and its integration with augmented reality (AR) technologies to enhance surgical precision, planning, and education. Drawing on recent evidence, neuroplastic collaboration improves graft patency, reduces ischemic complications, and shortens hospital stay in moyamoya revascularization. Parallel advances in AR enable immersive three-dimensional visualization, microvascular simulation, and intraoperative guidance. The combined neuroplastic-AR workflow enhances surgical accuracy, training efficiency, and patient safety, offering a sustainable framework for the next generation of cerebral revascularization.