Watch neurosurgeon Ed Smith explain moyamoya disease and its treatment.
At Boston Children’s, our Moyamoya Disease Program provides the full spectrum of diagnostic, consultation, surgical and follow-up care services for children and adolescents with Moyamoya disease. Our neurosurgeons and other clinicians are considered some of the world's foremost experts on the disease, so you can rest assured that your child is in good hands with us.
Our Moyamoya Disease Program specialists not only have extensive experience in treating this rare and complex disease; they also have specialized training in all aspects of pediatric medicine and surgery. That means that our surgeons, specialists, nurses and other health professionals understand the particular needs and concerns of young patients and their families.
We collaborate with our expert colleagues across the hospital—from neurologists, radiologists and anesthesiologists to physical therapists, social workers and speech therapists—to devise a comprehensive treatment plan that is right for your child and family.
Our specialists also conduct essential Moyamoya disease research into its causes, development and treatment. Our research efforts include:
studying how blood vessels in the brain respond to Moyamoya disease and to surgical treatment
examining the alterations of blood flow in the brains of children with Moyamoya
determining how certain components of the blood and cerebrospinal fluid may influence the onset and progression of Moyamoya disease
new methods of diagnosing Moyamoya disease at an early stage noninvasively, before disabling strokes occur
Did you know? The practice of pediatric neurosurgery has roots at Boston Children's
In 1929, Boston Children's physicians Harvey Cushing, MD, and Franc Ingraham, MD, established the Department of Neurosurgery at the hospital—marking the introduction of pediatric neurosurgery as a formally recognized field. Cushing and Ingraham, along with Donald Matson, MD, went on to write some of the most widely used and respected textbooks on pediatric neurosurgery, which are still considered required reading for aspiring neurosurgeons. Today, Boston Children's is one of the only pediatric hospitals in the world with full clinical programs devoted to rare illnesses like Moyamoya disease.
About Boston Children's Moyamoya Program
Boston Children’s Hospital has a long and distinguished history of caring for children with complex diseases and disorders of the brain, spine and central nervous system. Our Department of Neurosurgery is regarded as an international leader in understanding and treating pediatric Moyamoya disease, a rare, life-threatening condition that causes a slowing of the blood flow to the brain.
The only treatment for Moyamoya disease that’s proven to be effective in the long-term is surgery. Boston Children's has pioneered a procedure that directly applies a healthy artery onto the affected area of a patient's brain. In 1985, R. Michael Scott, MD, Boston Children's Neurosurgeon-in-Chief, performed the first of these operations, a procedure known as pial synangiosis—which he developed—on a child with Moyamoya disease. Over the past 25 years, he and colleague Edward Smith, MD, have used pial synangiosis to treat more than 400 children with Moyamoya.
Caring for children and young adults
Here at Boston Children's, we treat patients of various ages; while the average age at which a child is diagnosed with Moyamoya is 7, children of all ages can develop the disease, as can adults. Some children with Moyamoya are also living with other medical conditions, like Down syndrome, sickle cell disease and neurofibromatosis, and our clinicians work closely with specialists throughout the hospital to deliver comprehensive, multidisciplinary care.
As childhood strokes increase, surgeons aim to reduce risks
NPR’s “Morning Edition” features Boston Children’s Edward Smith, MD, in a story about Moyamoya and the journey of 13-year-old Boston Children’s patient Maribel Ramos.
Moyamoya Story on CBS 4 Boston
R. Michael Scott, MD, of Boston Children's Hospital treats Moyamoya patient with the surgery he pioneered.
In an ischemic stroke, accounting for nearly 90 percent of all stroke cases, it happens like this: When vessels supplying blood and oxygen to the brain are blocked by a narrowing or a clot, immune cells in the brain sense the low-oxygen conditions, suspect an invading organism and try to kill it by producing molecules known as reactive oxygen species or ROS’s.
These, unfortunately, have an inflammatory effect that actually damages the brain further, injuring and killing neurons.
“Stroke produces inflammation, and that’s one of the main things people have been after in trying to reduce stroke damage,” says David Clapham, MD, PhD, chief of the Basic Cardiovascular Research Laboratories at Boston Children’s Hospital.