Long-Term Outcome in China

Moyamoya disease (MMD) is not rarely detected in China. Currently, more than 50 neurosurgical institutions and 200 neurosurgeons are engaging in treating this complicated vascular disorder. In this chapter, we retrospectively reviewed the demographic data, clinical features, surgical strategies, and long-term outcomes of patients based on the literatures published by Chinese neurosurgical centers. In China, large national epidemiologic studies are still required. The largest series showed that the median age for the onset of symptoms was 30.36 years with the highest peak detection rate at 35–45 years of age and a smaller peak at 5–9 years of age. The disease occurred mainly in the Han people and was rarely seen in minority ethnicity. Treating modalities include direct bypass, indirect bypass, and combined bypass. Multimodal neuroimaging guided bypass surgery is also developing in some qualified centers. Based on Chinese reports, revascularization can help prevent further ischemic and hemorrhagic attacks. It can also improve the cognitive function in patients with cognitive impairment. Indirect bypass showed encouraging effect in pediatric patients. Although MMD is not rare in China, the management has not reached a consensus. More randomized controlled trials are needed to update the concepts and future perspectives in MMD.