AIM:

Moyamoya disease (MMD) is a slowly progressive bilateral stenocclusive process of the distal internal carotid presents with recurrent strokes. The purpose of this study was to identify clinical features, radiological features and outcome of the MMD after Multiple Burr Holes [MBH] .

MATERIALS:

Records of 9 children with MMD  treated from August 2009 until May 2018 was reviewed .MMD  was diagnosed by clinical features and neuroimaging.  MR Angiography was done in all children. Selection criteria for surgery were children with previous stroke and neuroimaging showing bilateral involvement MMD and after 10 weeks of the last stroke.

RESULTS:

Out of the 9 children, All the children had stroke and infarcts at presentation. Surgery was offered after mean of 12 weeks from the last stroke. Multiple burr holes were done in all the children. Follow up duration ranged from 3 months to 4 years with mean of 18 months. Except one child had developed stroke on after 5 days of surgery, all the children did not develop stroke and showed good revascularization on follow-up imaging.

CONCLUSION:

Indirect EC IC Bypass surgery in form of Multiple Burr Holes [ MBH] is an effective surgical treatment option for children with MMD with bilateral involvement. MBH is safe and recurrent stroke rate is lower than anticipated, on the basis of known natural history of MMD