Moyamoya is a progressive cerebrovascular disease in which there is stenosis and/or occlusion of blood vessels. The stenosis and/or occlusion of vessels (commonly circle of Willis and associated arteries) lead to formation of collateral vessels to compensate for reduced blood supply to the portion of brain posterior to the occlusion and/or stenosis. These collateral vessels in the angiogram present as hazy puff of smoke. As the disease was first described by Japanese team and “puff of smoke” in the local language means moyamoya, the disease came to be known as moyamoya.
Are There Any Natural Remedies For Moyamoya?
There is only one case report in literature so far as to the successful treatment of moyamoya by Gui-Zhi-Fu-Ling-Wan and Xiao-Xu-Ming-Tang Chinese herbal medication. Improvement on stagnated blood condition was noted in this case study. The decrease in blood viscosity led to increased flow of blood in the affected part. There have been some reports about chelation therapy too for the management of moyamoya; however, lack of any proven study or cases in the related field makes the option questionable. So far, there are no natural remedies for moyamoya.
Surgery forms the mainstay of the treatment. Surgery helps in revascularization of the brain parts not receiving enough blood or oxygen. Revascularization surgery helps prevent stroke in future and greatly improves quality of life in patients with moyamoya syndrome. Post moyamoya surgery patients are prescribed daily aspirin, which thins blood and facilitates blood flow through the graft.
Patients are also advised to stay hydrated as more water in the body will increase the volume of blood, which again increases the blood flow. Patients can also try incorporating healthy foods in their diet. They can quit smoking and alcohol consumption should be stopped.
Although, moyamoya can be fatal if left untreated as it is a progressive disease and disease progression will lead to recurrent strokes, which will further reduce the quality of life by affecting cognitive functions. Therefore, it is important to seek medical advice and treatment for the disease.
The cause of moyamoya still remains unclear. It is considered a genetic disorder in about 10% of cases. It has also been associated with other diseases, such as Down’s syndrome, Grave’s disease, neurofibromatosis type 1, anemias, Marfan syndrome, atherosclerosis, hypertension, radiation therapy, and tuberculosis.
It is more frequently seen in females than in males, in the ratio of 1.8:1. The disease onset has two peak ages. One is children below the age of 10 years and can be found in children as young as 6 months. The other is seen in adults in their 30-40s. Previously, the disease was thought to be found only in Asians countries (mostly in Japan), but according to latest statistics, it is prevalent all around the world. The disease is more common in Japan and Asian countries than anywhere else in the world.
Since the disease causes reduction in blood supply to parts of brain; it causes ischemia to the part receiving less blood. It also leads to abnormal collateral vessel formation to compensate for occlusion/stenosis of vessels, which may rupture as these vessels are too fragile. The ischemia to part of brain may lead to stroke or transient ischemic stroke and related symptoms, more commonly seen in children. The rupture of vessels leads to hemorrhage, commonly seen in adults. Most of the deaths in moyamoya are due to brain hemorrhage.
The presenting symptoms include, headache, seizure, weakness of part of face or arms along with paresthesias, cognitive disability, such as speech and language problems, visual changes and problem with balance.
The diagnosis of moyamoya is critical to timely treatment as most cases of moyamoya are misdiagnosed and delay in diagnosis leads to progression of disease. It can be diagnosed with angiography, including magnetic resonance angiography or computed tomography angiography. Laboratory tests can also help diagnose any underlying cause, such as elevated thyroid levels could suggest hyperthyroidism.
References:
https://www.ncbi.nlm.nih.gov/pubmed/1471616
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