Treatment of adult moyamoya disease by encephalo-duro-arterio-synangiosis: Five case reports.

Encephalo-duro-arterio-synangiosis (EDAS) is considered the surgical treatment of choice for most pediatric cases of moyamoya disease, but the success of this treatment in adults is less clear. We have compared pre- and postoperative angiograms of four adults and one adolescent with symptomatic moyamoya disease who underwent bilateral EDAS at Hermann Hospital in Houston. The postoperative follow-up period ranged from 6 to 18 months. The correlation of postoperative collateral flow and clinical course was good: of the three patients with documented collateralization, two experienced excellent clinical outcomes, and one experienced a good outcome. One patient had minimal collateralization and experienced progression of her neurologic symptoms. One patient experienced a good outcome and refused a postoperative angiogram.