Radical treatment of moyamoya disease

Moyamoya disease is a chronic pathology that affects cerebral vessels. In patients with moyamoya, main arteries of the brain become narrow and can’t provide sufficient blood supply. In order to compensate deteriorated blood flow, smaller arteries begin to widen and new tiny vessels grow.

It is believed that the pathology is caused by a genetic factor, as it is often diagnosed in members of one family. Other possible causes include autoimmune disorders, fibromuscular dysplasia and cranial trauma.

Symptoms of the pathology

Symptoms of moyamoya disease are caused by two factors: cerebral hypoxia due to blockages of vessels and formation of new, abnormal artery clusters. Patients usually have the following complaints:

●    Headaches
●    Blurred vision
●    Numbness and/or weakness in the extremities, usually unilateral
●    Seizures or seizure-like episodes
●    Uncontrolled and involuntary movements
●    Speech disturbances
●    Psychomotor retardation in children
●    Decline of cognitive functions in adults

Symptoms usually reveal themselves during the physical exertion – sports training, intensive coughing, crying. Other trigger factors include fever and arterial hypertension.
Moyamoya disease diagnostics

Diagnostics of the pathology includes a number of investigations that allow visualizing cerebral vessels and checking their function:

●    MRI and CT scans provide a comprehensive picture of the whole brain
●    Cerebral angiography is a direct vessel examination that includes highlighting them with special contrast agent
●    Transcranial Doppler ultrasound examination provides information about vessels’ structure and intensity of blood flow
●    PET and SPECT scans reflects brain functional activity
●    Electroencephalography measures electrical activity of the brain

Only well-equipped hospitals abroad are able to carry out all the necessary examinations and ensure reliable result of the diagnostics.

Approaches to treatment of moyamoya

 Moyamoya disease treatment tactics includes drugs administration and surgery. Drug intake can
prevent stroke in some measure and improve headache and seizures.

During the direct revascularization, or direct bypass surgery, a doctor connects a superficial scalp artery to a brain artery. This allows for passing narrowed vessel segments and restoring normal blood flow.

Indirect revascularization, or indirect bypass surgery, involves gradual growing of normal superficial arteries into the brain tissue. A healthy scalp artery is attached to the brain surface through a hole in the skull. Over time, the artery forms new branches inside cerebral tissue.

Surgery is more preferable than drug treatment, as it reduces hemorrhage risk more significantly and doesn’t require lifelong medications intake.

Clinics that help patients with moyamoya

In order to provide effective treatment with a low rate of complications, hospitals should have state-of-art equipment for neurosurgical interventions and a well-coordinated team of doctors (neurosurgeons, neurologists, therapeutists). World leading hospitals that offer moyamoya disease treatment include:

●    University Hospital of Ludwig Maximilian, University of Munich, Germany
●    Charite University Hospital, Berlin, Germany
●    University Hospital HM Monteprincipe, Madrid, Spain
●    University Hospital for Neurosurgery, Salzburg, Austria
●    Tel Aviv Sourasky Medical Center, Israel

All of these hospitals admit patients from abroad provided that they have a visa, correctly prepared medical documents, and invitation for treatment.

Cost of treatment
 
Patients with moyamoya disease usually require thorough diagnostics followed by individually chosen neurosurgical intervention. Moyamoya surgery cost mainly depends on the country, level of the hospital, and doctor. Surgery price starts from 7,215€ in Thailand, from 8,485€ in India, and from 9,793€ in Spain. Price for diagnostics starts from 535€ in Thailand, from 876€ in Turkey, and from 1,725€ in Germany.

In order to choose the best hospital exactly for your case, you should contact Booking Health. Booking Health is the only international certified medical tourism operator. We will guide you through the whole process of treatment abroad, assisting with all medical and organizational aspects.

This is a guest blog entry.