Moyamoya Disease

Moyamoya Disease

Moyamoya disease is a rare but serious condition affecting the blood vessels in the brain. It results in narrowed or blocked arteries at the base of the brain, which limits blood flow and increases the risk of transient ischaemic attacks (TIAs), strokes, and cognitive impairment.

At The Royal Buckinghamshire Hospital, we offer specialist neurorehabilitation for adults recovering from the effects of Moyamoya disease. Whether you’re recovering from a stroke, surgery, or cognitive symptoms, our inpatient programmes are designed to restore independence, mobility, and mental clarity.

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What Is Moyamoya Disease?

Moyamoya disease occurs when the internal carotid arteries — major vessels supplying the brain — gradually narrow or become blocked. To compensate, the brain attempts to grow small, fragile blood vessels, which resemble a “puff of smoke” on imaging (moyamoya in Japanese).

These fragile vessels are prone to rupture or insufficient supply, leading to:

• Ischaemic strokes (due to reduced blood flow)
• Haemorrhagic strokes (due to bleeding from weak vessels)
• Cognitive changes
• Seizures or movement disorders

Although more common in children and individuals of East Asian descent, Moyamoya can occur at any age and in all ethnic groups.

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Symptoms of Moyamoya Disease

Symptoms depend on the type of event (ischaemic vs haemorrhagic) and the area of the brain affected. Adults often experience:

• Transient ischaemic attacks (TIAs)
• Ischaemic strokes with sudden weakness or numbness
• Headaches or migraines
• Cognitive decline or memory issues
• Difficulty speaking or understanding language
• Visual disturbances
• Seizures

Some people may remain undiagnosed until they experience a stroke or sudden neurological episode.

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What Causes Moyamoya Disease?

In many cases, Moyamoya disease is idiopathic — meaning it has no known cause. However, some individuals develop Moyamoya syndrome, where similar changes occur due to an underlying condition, such as:

• Neurofibromatosis type 1
• Sickle cell disease
• Down syndrome
• Radiation therapy to the head or neck
• Autoimmune disorders

There may also be a genetic link in some families, particularly among East Asian populations.

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Diagnosis

Diagnosis typically involves:

• MRI and MRA (magnetic resonance angiography)
• CT angiography
• Cerebral angiogram – considered the gold standard for confirming diagnosis
• Neurocognitive testing (if cognitive decline is suspected)

Once diagnosed, treatment is focused on stroke prevention and managing symptoms.

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Treatment Options

Surgical revascularisation is often recommended to restore blood flow to the brain. These procedures may include:

• Direct bypass surgery – connecting an external artery to a brain artery
• Indirect bypass procedures – encouraging new vessels to grow over time

Medical therapy may also include:

• Antiplatelet agents (e.g., aspirin)
• Blood pressure management
• Seizure control
• Regular imaging follow-up

Even after treatment, some individuals experience long-term symptoms requiring ongoing support.

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Rehabilitation After Stroke or Surgery

At The Royal Buckinghamshire Hospital, we provide inpatient neurorehabilitation for adults recovering from:

• Stroke caused by Moyamoya disease
• Post-operative cognitive or motor impairments
• Progressive decline related to vascular insufficiency
• Seizure-related injuries or movement disorders

Our multidisciplinary team offers:

• Physiotherapy – for strength, balance, and mobility
• Occupational therapy – to promote independence with daily activities
• Speech and language therapy – for communication or swallowing issues
• Neuropsychology – to support cognition, memory, and emotional wellbeing
• Specialist nursing care – in a supportive, neuro-specialist environment

Each programme is personalised to meet the unique needs of the patient.

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Who We Help

We welcome adult patients (aged 18+) who:

• Have had a stroke related to Moyamoya disease
• Are recovering after surgical revascularisation
• Are living with physical, cognitive, or emotional effects of the condition
• Need a structured neurorehabilitation plan following hospital discharge

To enquire about treatment or make a referral, please call 01296 678800 or contact us online.

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Why Choose The Royal Buckinghamshire Hospital?

• Specialist in complex neurological rehabilitation
• Multidisciplinary care tailored to each patient’s needs
• Calm, consultant-led inpatient environment with 24/7 support
• Experience with rare and high-risk stroke conditions
• Trusted by patients and families across the UK