• Hanhai Zeng, Yinghan Guo, Yin Li, Xiaobo Yu, Feng Yan, Xiaoxiao Tan, Hangzhe Xu, Yucong Peng, Jianfeng Zhuang, Hang Zhou, Xiongjie Fu, Lin Wang, and Gao Chen.
• Department of Neurological Surgery, The Second Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, Zhejiang Province, China.
• World Neurosurg. 2021 Feb 1; 146: e955-e960.

ObjectiveThe best management of asymptomatic moyamoya disease (MMD) remains controversial. In this study, the authors aimed to explore an experience for treatment modality for asymptomatic MMD.MethodsThe authors retrospectively reviewed a total of 23 patients (age range 30-58 years) with asymptomatic MMD during the past 5 years at their institutions. The patients were divided into 2 groups: The surgical group included 11 patients, and the conservative group included 12 patients. The demographic, radiologic, and clinical findings of the patients were evaluated. At follow-up over 13-65 months, the future clinical and radiologic progression events were evaluated.ResultsDuring the follow-up period, 3 patients suffered from future clinical progression events in the conservative group: 1 experienced stroke, and 2 experienced transient ischemic attack. Among the patients in the surgical group, only 1 experienced transient ischemic attack. Kaplan-Meier analysis showed that patients undergoing surgeries had longer clinical progression-free survival times compared with patients in the conservative group (P = 0.002).ConclusionsSurgical treatment may be an alternative choice for patients with asymptomatic MMD. However, the best strategy for asymptomatic MMD in order to reduce future cerebrovascular risks still needs to be further explored.Copyright © 2020 Elsevier Inc. All rights reserved.

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