Moyamoya Disease Treatments

Moyamoya disease is a rare vascular pathology that manifests itself in a slowly developing narrowing of the intracranial cerebral arteries with the formation of additional bypass pathways. Treatment of Moyamoya disease in Israel is carried out by highly qualified neurologists and neurosurgeons, many of whom are among the world’s leading specialists in this field. The therapy regimen includes both various types of modern drugs and neurosurgical operations, the purpose of which is the formation of a vascular shunt. Timely surgical treatment in more than 80% of cases normalizes the patient’s condition and provides a favorable prognosis.

In Israeli clinics, great attention is paid to the formulation of the correct diagnosis, which is necessary for the development of an adequate therapy program. Equipping diagnostic departments with modern equipment makes it possible in the shortest possible time to establish the causes of the manifested violations, describe the characteristic signs of pathology, and assess the general condition of the patient. In addition, the diagnostic techniques used make it possible to accurately carry out differential diagnostics with a number of diseases with similar symptoms. Patients who leave reviews on the websites of Israeli clinics emphasize the effectiveness, comfortable conditions for treatment and an acceptable cost of treatment, the competence and attentiveness of the medical staff.

Signs and symptoms of Moyamoya disease

The manifestation of Moyamoya disease includes transient ischemic episodes. Young patients may experience episodes of hyperventilation, fever, which is preceded by vigorous physical activity. In rare cases, the initial manifestation of the disease may also include headaches, which occur mainly in the morning and are accompanied by nausea, chorea-like movement disorders that can be caused by exercise or emotional stress.

Symptoms of Moyamoya disease appear at about the age of five and in patients of 30-40 years old, and women suffer from this pathology more often than men. The disorders are based on progressive stenosis of the part of the carotid artery passing inside the human skull, separate sections of the cerebral arteries. To ensure blood supply to the brain, a collateral vascular network develops. The causes of the pathology are still not clearly understood, but, presumably, the main role belongs to genetic factors. In addition, autoimmune reactions and inflammatory processes contribute to the development of the disease.

Clinical symptoms are associated with chronic cerebral ischemia and hemorrhages from collateral blood vessels. In pediatric patients, the first sign of the disease is transient ischemic attacks (TIA), manifested in hemiparesis, speech disorders, visual impairment, and epileptic seizures. In adult patients, subarachnoid hemorrhages, intense headaches, tinnitus, coordination disorders, and nystagmus develop. The most serious complications of Moyamoya disease are ischemic or hemorrhagic strokes.

Moyamoya disease treatment methods

Moyamoya disease is a disease of the cerebral arterial vessels that is diagnosed in a small number of patients. The pathology was described in the 60s of the last century by Japanese specialists, and not long before that it was believed that it occurs exclusively among the Japanese. However, it was soon discovered that a similar disease is common in other parts of the world, but most often it develops in Asians. The pathology received its name, translated from Japanese, meaning “like the smoke of a cigarette,” thanks to the characteristic picture obtained with angiography.

The treatment program includes drug therapy and surgical treatment.

Drug therapy

As practice shows, a course of drugs does not stop the progression of the disease and can only be used as symptomatic therapy. To relieve symptoms, patients are prescribed:

  • agents that improve the condition of blood vessels;
  • neurometabolic drugs (nootropics, gamma-aminobutyric acid and others).

Surgery

The goal of neurosurgical operations is to form a shunt through which blood circulates around the narrowed arteries.

For this, various methods of surgical intervention are used.

  • Direct method – the formation of a direct anastomosis between the extracranial artery and the intracranial arterial vessel. During the operation, the artery supplying blood to the scalp is connected to one of the cerebral arteries. The procedure is one of the most complex neurosurgical operations, which is explained by the small size of the cerebral arteries and the need for temporary arrest of blood circulation, which is associated with the risk of intraoperative development of cerebral infarction.
  • Indirect bypass surgery – the artery responsible for the blood supply to the scalp connects to the cerebral cortex. The disadvantage of the procedure is the achievement of normal indicators of blood supply to the brain only after 6-12 months, necessary for the formation of small-caliber vessels.
  • Dural inversion – during the operation, the outer layer of the dura mater, penetrated by an extensive network of blood vessels, connects to the cerebral cortex, thereby becoming a source of additional vessel formation, which significantly improves cerebral circulation.

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How is the diagnosis of Moyamoya disease

In Israeli clinics, a comprehensive examination of a patient, diagnosis and development of a treatment program takes, on average, three days.

First day

On the day of admission to the clinic, the patient visits the leading neurosurgeon. At the initial consultation, the doctor examines the medical history, the results of previous studies, medical reports, and learns from the patient about previous acute cerebrovascular accidents. After the neurological and physical examinations, the specialist makes a list of required examinations.

Second day

Performing the prescribed types of diagnostic procedures:

  • consultation with an ophthalmologist – the patient is tested for visual acuity, perimetry, assessment of the condition of the fundus (ophthalmoscopy);
  • electroencephalogram (EEG) – changes characteristic of Moyamoya disease make it possible to use this method as a screening method;
  • transcranial dopplerography;
  • computed tomography (CT) of the brain – shows small foci of reduced density;
  • magnetic resonance imaging (MRI) of the brain – using this informative method, infarction foci, atrophic changes, pathologically altered vessels are identified;
  • angiography of cerebral vessels – acts as the gold standard in diagnostic examination, this pathology is characterized by the presence of a picture on the base of the brain that resembles a cloud of cigarette smoke;
  • CT and MRI of cerebral vessels.

Third day

The results obtained are submitted for consideration by a council, which includes a neurologist, neurosurgeon and highly specialized specialists. After analyzing the data, doctors collegially establish a diagnosis and develop a treatment regimen.

How much does the treatment cost

The price determined after the examination and the appointment of treatment is invariably of interest to medical tourists. The passage of therapy in Israeli clinics allows the patient to save about 30% of the amount required in Western European countries, and about 50% of the money spent in the United States.

Benefits of treatment

  • The effectiveness of the treatment.
  • Highly qualified doctors, many of whom have a worldwide reputation.
  • Excellent material and technical base of clinics.
  • Accurate diagnostics.
  • Affordable prices.

Successful Moyamoya disease treatment, in particular, the necessary neurosurgical operation, will stop the progression of the disease and avoid the development of complications. In order to restore health and quickly return to your usual life, contact the chosen clinic and undergo the prescribed course of therapy.

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