[Evidence for Antiplatelet Drug Therapy for Moyamoya Disease].

Currently, no randomized clinical trials have investigated the use of antiplatelet drugs to prevent stroke in patients with Moyamoya disease(MMD). Notably, most of these studies were retrospective observational or prospective with small cohorts. Although the effectiveness of antiplatelet drug administration for ischemic MMD is limited, patients with microembolic signals detected using transcranial Doppler ultrasound may benefit from the prevention of cerebral infarction. There are no data that the administration of antiplatelet drugs increases the risk of hemorrhagic stroke in patients with MMD. However, administration of antiplatelet drugs may increase the patency rate of bypass blood vessels after bypass surgery. Among antiplatelet drugs, cilostazol has a clinically beneficial effect in patients with MMD through its multifaceted effects, such as increasing cerebral blood flow and inhibiting cognitive decline.