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Dr. Andrew Rynne

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Suggest treatment for Moyamoya disease in an elderly person

Answered by
Dr. Olsi Taka


Practicing since :2004

Answered : 3633 Questions

Posted on Sat, 4 Mar 2017 in Brain and Spine
Question: My daughter ,age 59, has moyamoya, diagnosed about 6 years ago as probably she has had it 15 years , she had a massive stroke after several small ones in about 2000 leaving her with aphasia. She is good health otherwise except for morbid obesity [275] . What can we expect now ? She is on Plavix but has had a couple lighter stokes since with no apparent further damage to her brain. Last check up gave her only a year or two life expectancy, it is spreading.
Answered by Dr. Olsi Taka 4 hours later
Brief Answer:
Read below.

Detailed Answer:
I read your question carefully and I understand your concern.

Patients with XXXXXXX XXXXXXX can potentially suffer two main complications, ischemia or hemorrhage. Given her age I suppose she has the adult form where the greatest danger is hemorrhage. When a blood vessel is going to rupture and how much will bleed is not possible to predict with certainty, of course as the changes in blood vessels increase the risk will augment, but there is no exact formula to predict when the next event will happen and how severe it will be. It also depends on presence of aneurysms on vessel imaging.

However there are surgical methods which can be attempted. Admittedly in the adult form they are not as effective as in the childhood form, but still there are surgical procedures which attempt to restore some circulation to those areas by creating connections with other arteries from which blood supply can be taken. It serves mainly to avoid ischemia, lack of blood supply, but also it can stop or at least slow down the development of blood vessels. Also if any aneurysm are present they can be treated surgically as well lowering the risk of hemorrhage. So while the risk for hemorrhagic or ischemic stroke is imminent, perhaps that 1-2 years prediction can improve life expectancy.

I remain at your disposal for other questions.
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar

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