What question did this study set out to answer?

This study aims to compare perioperative complications and long-term stroke risk between ischemic-type and hemorrhagic-type moyamoya disease after revascularization surgery.

June 14, 2026Neurosurgery

Distinct Clinical Phenotypes in Moyamoya Disease: A Multicenter Comparison of Ischemic and Hemorrhagic Presentations

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Authors

VEVictor Gabriel El-HajjThomas Jefferson University Hospital BMBasel MusmarThomas Jefferson University Hospital JRJoanna M. RoyThomas Jefferson University Hospital

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Implication

Multicenter retrospective study compares complications and stroke risk in ischemic versus hemorrhagic Moyamoya disease.

Key Points

This study aims to compare perioperative complications and long-term stroke risk between ischemic-type and hemorrhagic-type moyamoya disease after revascularization surgery.
Conducted a multicenter retrospective cohort study across 13 North American academic centers from 2008-2022.
Included 485 patients with 502 revascularized hemispheres for angiographically confirmed moyamoya disease.
Used propensity score matching (2:1) and multivariable logistic regression for analysis.
Ischemic-onset MMD had a significantly higher overall postoperative complication rate of 10% compared to 2.6% for hemorrhagic onset (P = .043).
Long-term follow-up indicated ischemic presentation led to predominantly ischemic recurrences, while hemorrhagic presentation had higher rates of hemorrhagic strokes (P < .001).
In the sensitivity cohort, hemorrhagic presentation was associated with an 8-fold increased risk of long-term stroke compared to ischemic presentation (adjusted odds ratio 8.23; 95% CI 1.84-36.8; P = .006).

Cite This Study

El-Hajj et al. (2026) studied this question.

synapsesocial.com/papers/6a2e46b3b1cc60ccdea8b51d https://doi.org/10.1227/neu.0000000000004125

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Distinct Clinical Phenotypes in Moyamoya Disease: A Multicenter Comparison of Ischemic and Hemorrhagic Presentations

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Cite This Study

Distinct Clinical Phenotypes in Moyamoya Disease: A Multicenter Comparison of Ischemic and Hemorrhagic Presentations

Discussion

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Implication

Key Points

Cite This Study

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