**8. Diagnostic guidelines**

The advancements in various diagnostic modalities lead to the formulation of diagnostic guidelines for Moyamoya disease shown in **Table 4** [5].

### **8.1 Treatment**

Moyamoya disease is a chronic progressive disease described earlier, leading to recurrent strokes due to internal carotid artery occlusion and ischemia due to narrow, low caliber collaterals. The illness's mainstay is revascularization surgery


## **Table 4.**

*Diagnostic guidelines for Moyamoya disease.*

to increase the intracranial blood flow using extracerebral blood vessels by direct bypass or pialsynangiosis. The decision for surgical intervention is based on the patient's age, symptomatic/asymptomatic disease, ischemic/hemorrhagic manifestations, presence/absence of aneurysm and risk of recurrence.

The indication of surgery can be briefly summarized as follows in **Figure 4** [33].
