Western Moyamoya Phenotype: A Scoping Review

Abstract

Moyamoya, a rare angiographic finding, is characterized by chronic and progressive stenosis at the terminal end of the internal carotid artery, followed by collateralization of the cerebral vasculature at the base of the skull. Coined by Suzuki and Takaku in 1969, the term “moyamoya” means a “puff of smoke” in Japanese, a reference to the angiographic appearance of moyamoya collateralization. Moyamoya is most commonly found in East Asian countries, where much governmental and civilian effort has been expended to characterize this unique disease process. However, despite its rarity, the occurrence of moyamoya in Western countries is associated with significant divergence regarding incidence, gender, sex, age at diagnosis, clinical presentation, and outcomes. Here, we attempted to review the Western literature on moyamoya presentation using the PubMed database to characterize the Western phenotype of moyamoya. We were guided by the Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for scoping reviews (PRISMA-ScR). We reviewed papers generated from a search with keywords “moyamoya case report,” those reported from a Western institution, and those reported on a relevant association. Our scoping review demonstrated various clinical associations with moyamoya. Moreover, we summarized the demographic profile and clinical symptomatology, as well as reported disease associations to better elucidate the Western phenotype of moyamoya.

Unusual presentation of acquired thrombotic thrombocytopenic purpura (TTP) versus catastrophic antiphospholipid syndrome in a patient with Moya‐Moya disease, case report, and literature review

“…Autoimmunity has been documented in MMD and MMS; however, the specifics associations with immune disorders such as SLE, APLS, and further have not been documented. (Sigdel et al, 2013) (Miller et al, 2021).…”

“…Furthermore, the incidence reported between Asian and Asian American descendants was similar. 9 , 10 meaning that genetic factors have to be implicated in disease development. 11 …”

“…We found 16 papers describing an association between moyamoya and hematologic disorders (spherocytosis, beta‐thalassemia, Fanconi anemia, etc.). 10 …”

A challenging diagnosis and management of patient acquired thrombotic thrombocytopenic purpura (TTP) versus catastrophic antiphospholipid syndrome in a patient with Moya-Moya disease, case report, and literature review

“…We found 16 papers describing an association between moyamoya and hematologic disorders (spherocytosis, beta-thalassemia, Fanconi anemia, etc.) (11).…”

“…Furthermore, the incidence reported between Asian and Asian American descendants was similar. (10) (11), meaning that genetic factors have to be implicated in disease development. (12).…”