Moyamoya disease is a rare pathology characterized by stenosis of the intracranial cerebral arteries and the formation of collateral vessels that provide blood supply to the brain. Treatment of Moyamoya disease in Israel involves modern surgical methods of vascular bypass surgery that create an artificial blood flow, ensuring blood circulation around the narrowed arterial vessels. The professional conduct of surgical interventions by highly qualified Israeli neurosurgeons allows for normalization of the patient's condition in more than 83% of cases and provides a favorable prognosis.
Moyamoya disease is a rare pathology characterized by stenosis of the intracranial cerebral arteries and the formation of collateral vessels that provide blood supply to the brain. Treatment of Moyamoya disease in Israel involves modern surgical methods of vascular bypass surgery that create an artificial blood flow, ensuring blood circulation around the narrowed arterial vessels. The professional conduct of surgical interventions by highly qualified Israeli neurosurgeons allows for normalization of the patient's condition in more than 83% of cases and provides a favorable prognosis.
Treatment Methods for the Disease
Moyamoya disease, thoroughly described by Japanese clinician researchers, is extremely rare, and until the 1960s, it was believed to affect only Japanese people. It has since been proven that this pathology also affects residents of other countries, although in most cases it develops in Asians. The name of the disease, which translates from Japanese as "like a cloud of cigarette smoke," is related to the characteristic angiographic pattern. The first symptoms of the disease manifest in patients in two age groups: approximately at 5-7 years and at 30-40 years.
To date, the causes of Moyamoya disease have not been definitively established. Recently, it has been found that vascular anomalies arise as a result of genetic mutations. According to other researchers, the disease is provoked by an inflammatory process and develops as a result of autoimmune reactions.
The symptoms are due to the development of chronic ischemia of the brain, as well as hemorrhages due to the disruption of the integrity of collateral vessels. In children, the disease manifests with signs of transient ischemic attack: hemiparesis and epileptic seizures, decreased visual acuity, and speech disturbances. In adult patients, subarachnoid hemorrhages, persistent severe headaches, nystagmus, coordination disorders, and tinnitus are noted.
The treatment scheme includes medication and neurosurgical operations.
Medication Treatment
It should be noted that drug therapy is prescribed solely as symptomatic treatment, as it has been proven that a medication course cannot stop the progression of the pathology. The therapeutic scheme includes medications that strengthen the vascular wall and normalize the functioning of the circulatory system, as well as neurometabolic agents (nootropic drugs, gamma-aminobutyric acid, and others).
Surgical Treatment
During the surgical intervention, a shunt is formed, providing an alternative path for blood circulation that bypasses the stenosed arteries.
The following types of operations are performed:
- Direct method (anastomosis between extracranial and intracranial arteries) — during the intervention, the arterial vessel supplying blood to the scalp is connected to one of the cerebral arteries. This neurosurgical operation is considered one of the most complex, as the small size of the cerebral arteries is combined with the required cessation of blood circulation, which threatens the development of a stroke during the procedure. The advantages of the method, which is considered the standard for surgical treatment of Moyamoya disease, include immediate improvement in cerebral blood supply and rare development of ischemic attacks after this operation.
- Indirect method — a connection is formed between the artery responsible for supplying blood to the scalp and the cerebral cortex. One of the main disadvantages of this method is the prolonged time required for the formation of small-caliber vessels. As a result, blood supply to the brain normalizes only 6-11 months after the operation.
- Dural inversion — a surgery aimed at connecting the vascular-rich outer layer of the dura mater with the cortex, resulting in the formation of additional blood vessels.
Diagnostic Methods for the Disease
In Israeli clinics, a comprehensive examination of the patient, determination of the exact cause of the emerging disorders, and construction of a treatment scheme take about three days.
During the initial consultation with the leading neurosurgeon, which takes place on the first day of the patient's stay in the clinic, the doctor reviews the medical history and patient’s background, results of earlier studies, and clarifies the nature and timing of the troubling symptoms. After conducting a neurological examination, the neurosurgeon prescribes the necessary tests. Additionally, the patient is referred for an ophthalmologist consultation, during which visual acuity testing (visometry), perimetry (determining the field of vision), and ophthalmoscopy (examination of the fundus) are performed.
Undergoing the prescribed diagnostic procedures:
- imaging methods (CT and MRI of the brain and cerebral blood vessels) — conducted to identify pathological changes in the brain vessels, infarction foci;
- electroencephalogram (EEG) — an informative, screening method that demonstrates changes characteristic of this pathology;
- angiography of cerebral vessels;
- transcranial Doppler ultrasound.
The results of the studies are reviewed by a medical commission consisting of a neurosurgeon, neurologist, and narrow-profile specialists. After studying the obtained data, the doctors jointly
establish the final diagnosis and develop a therapy scheme.
How Much Does Treatment Cost
The cost of the therapeutic course is of interest to most medical tourists. Treatment in medical centers in Israel costs patients about 30% less than in Western European countries and allows for savings of about 50% of the amount required for treatment in the USA.
Advantages of Treatment in Israel
- Effectiveness of the prescribed treatment course.
- High level of qualification and many years of experience of doctors.
- Equipping clinics with modern medical equipment.
- Professional conduct of the most complex neurosurgical operations.
- Loyal prices.
Timely adequate treatment is necessary to eliminate the symptoms of the disease and prevent complications. By contacting an Israeli clinic, you can quickly get rid of the disease and regain the ability to lead a normal active life.