Moyamoya Syndrome in Adults (Age 18+): Managing the Asymptomatic Patient
This protocol addresses the specific clinical scenario of an adult patient (aged 18 years or older) with Moyamoya syndrome who is currently asymptomatic — no cerebrovascular symptoms — and who has not had a haemorrhagic presentation.
Clinical Scenario
Adult (age 18 or older) · Asymptomatic (no cerebrovascular symptoms) · No haemorrhagic presentation. This patient profile calls for a conservative management strategy, distinct from the approach used in symptomatic or post-haemorrhagic Moyamoya disease.
Treatment Approach
Current evidence supports conservative management with long-term antiplatelet therapy as the primary strategy in this setting, aimed at reducing embolic stroke risk. The full protocol specifies which agent applies and the clinical criteria governing its use.
Complete agent selection, regimen details, and decision criteria are available in the full protocol below.
References
DOI: 10.1177/23969873221144089
- In adult MMA asymptomatic patients, we suggest considering conservative treatment except in patients with both cerebral haemodynamic impairment and silent ischaemic lesions in the same cerebral region.
- In patients with non-haemorrhagic MMA, we suggest the use of long-term antiplatelet therapy to reduce the risk of embolic strokes without an increase in haemorrhagic strokes.