Diagnosis of Moyamoya - Methods

I wanted to mention this as it was discussed on the "other" board recently and the discussion was about how to diagnose Moyamoya.

In the article listed below (Sept 2008 STROKE) they addressed this VERY specifically regarding children! Basically what you want to know is this, there CAN be complications when doing angiograms with children. That makes sense, their veins are much smaller than us adults!!

They DO perform the angiograms at times, that is something you and the Doctor should be discussing, but the actual diagnosis of Moyamoya CAN be done with MRI / MRA, please read the following quote!!

http://preview.tinyurl.com/6eunot

---
"Most suggestive of moyamoya on MRI is the absence of flow voids in the ICA, MCA, and ACA coupled with abnormally prominent flow voids from basal ganglia and thalamic collateral vessels. These imaging findings are virtually diagnostic of moyamoya syndrome.138,143–147

Because of its excellent diagnostic yield and noninvasiveness, MRA has largely supplanted CA as the primary diagnostic imaging modality for moyamoya syndrome.143,148–153

However, although MRA affords the ability to detect stenosis of major intracranial vessels and to visualize the basal collateral vessels, MRA is less reliable when applied to smaller vessel occlusions. In a study of 190 angiograms from pediatric patients, the complication rate from angiography in children with moyamoya syndrome was no higher than the risk of angiography in nonmoyamoya populations with other forms of cerebrovascular disease."