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We analyzed the effect of superficial temporal to middle cerebral artery (STA-MCA) bypass to prevent future strokes based on the data of the clinical course and the course of the collateral circulation. Thirty-five patients with hemorrhagic type moyamoya disease were examined during the follow-up period with a mean of 6.3 years after the initial intracranial hemorrhage. Eighteen patients were conservatively managed, 12 patients underwent STA-MCA bypass, and the last 5 patients underwent encephaloduroarteriosynangiosis (EDAS). The ophthalmic artery flow was examined as the collateral circulation using the color Doppler flow imaging (CDFI). During the follow-up period, 13 patients (43%, 5.86%/patient/year) experienced a cerebral event such as ischemia or rebleeding. The incidence of a future stroke event in the patients treated with STA-MCA bypass (ppp Clinical symptoms and ophthalmic artery CDFI findings confirmed that STA-MCA bypass in patients with hemorrhagic type moyamoya disease prevents future strokes.

Course of the Hemorrhagic Type Moyamoya Disease: Based on the Data of Re-hemorrhage and Collateral Circulation