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Moyamoya care · India
Compassionate diagnosis, expert evaluation, and personalized treatment for patients living with Moyamoya disease.
You are not alone, and Moyamoya is treatable. Let’s take it one step at a time.
A normal, busy life
Meera, 27, is healthy and active — work, friends, family and her morning chai.
Illustrative story. Every patient is different — please talk to the team about your own care.
Good to know
It is treatable
Surgical revascularization is the most effective treatment. It restores blood flow to the brain and significantly lowers the risk of future strokes.
Not immediately life-threatening
Moyamoya is not an immediately life-threatening disease. Life expectancy is similar to the general population if treated promptly.
Surgery is generally safe
When performed by experienced cerebrovascular neurosurgeons, revascularization surgery is generally safe and has a high success rate.
Recovery is quick
Hospital recovery typically takes around 5–7 days. Most patients return to normal activities within 4–6 weeks.
Understand it simply
In simple words: the brain’s main arteries slowly narrow, so the body grows tiny new vessels to keep blood flowing. On a scan these look like a ‘puff of smoke’, which is what moyamoya means in Japanese.
A disease where the major blood vessels supplying blood to the brain progressively shut off, resulting in strokes. Natural attempts at improving blood supply to the brain occur through collateral blood vessels.
Healthy: The main artery is wide open. Blood flows freely into the brain.
Think of a water pipe slowly getting blocked: less water reaches the tap, so the body opens tiny side channels to keep the brain supplied.
The commonest presentation is recurrent stroke (weakness of hands or legs, facial deviation, slurring or loss of speech, vacant stare or loss of consciousness) and affects children and adults. Patients recover from stroke after a short time (Transient ischemic attacks – TIA). Sometimes, major strokes occur due to lack of blood supply to the brain or bleed in the brain. Some patients present with intractable headache only.
Ischemic Moyamoya
Due to deficiency of blood supply
When the collateral channels fail to provide adequate blood supply to the brain, strokes occur.
Hemorrhagic Moyamoya
Due to bleed in the brain
Rarely, the collateral channels become engorged and rupture, resulting in a bleed in the brain.
Who can be affected?
‘Puff of smoke’Signs to watch for
Any of these, especially when they repeat, should prompt a check for Moyamoya. Most of them pass quickly, which is exactly why they are easy to miss.
Transient ischemic attacks (TIA)
Minor strokes — transient limb weakness that recovers after a short time.
Transient limb weakness
Minor strokes — an arm or leg suddenly goes weak, then strength returns.
Transient limb shaking
Limb-shaking TIA — rhythmic, involuntary shaking of an arm or leg.
Permanent limb weakness
Lasting weakness of a limb after a major stroke.
Speech difficulty, loss of speech
Slurred, halting or absent speech.
Headaches, migraine
Throbbing or persistent head pain.
Seizures (fits)
Sudden episodes of abnormal movements or loss of awareness.
Staring spells, transient visual blurring
A vacant, unresponsive stare or blurred sight.
Recurrent syncope / drop attacks
Sudden loss of consciousness or a fall.
Noticing a sign does not mean the worst. It means it is worth a conversation with a specialist.
Because mini-strokes recover quickly, the signs are often dismissed. These patterns — especially in children — should raise suspicion.
Patients may complain or may be noticed to have weakness of limbs. This improves in a short time, so that at the time of examination in a clinic, the patient may be normal. In children, the symptoms may be dismissed by the parents and the doctor. Recurrent such episodes in children and adults must raise the suspicion of Moyamoya angiopathy.
Limb weakness that occurs in patients who suffer dehydration:
Stroke that occurs in the following situations:
Your care journey
Most people follow the same four steps. We guide you through each one.
Meet the team and share your history and any earlier scans. Early, correct diagnosis under experienced doctors gives the best outcomes.
Diagnosis usually follows three imaging steps: an MRI scan of the brain, a Digital Subtraction Angiogram (DSA) and MR Perfusion imaging.
MRI · FLAIR
DSA · ICA
CBF map
Remain well hydrated, avoid over-exertion and keep a simple diary. Medications such as blood thinners (Aspirin and Clopidogrel) and Cilostazol have limited benefit in Moyamoya angiopathy.
Medications such as blood thinners (Aspirin and Clopidogrel) and Cilostazol have limited benefit in Moyamoya angiopathy.
Moyamoya angiopathy is a rare disease. A delay in diagnosis could lead to poor outcomes of treatment. It is important to secure the correct diagnosis at the earliest.
Early revascularization surgery is beneficial. Hospital recovery typically takes around 5–7 days, and most patients return to normal activities within 4–6 weeks.
Direct · Brain bypass
Direct revascularization surgery (Brain bypass surgery)
A scalp artery (STA) is stitched onto a brain vessel (MCA).
Indirect · New vessels
Indirect revascularization surgery
Over weeks, it grows tiny new vessels — like roots.
Surgery has the most benefit before a major stroke causes permanent damage — which is why early diagnosis matters so much.
Direct revascularization surgery (Brain bypass surgery)
A tiny blood vessel from the scalp is harvested and surgically connected to a blood vessel in the brain. This surgery allows blood to bypass the obstruction in the internal carotid artery and reach the brain. This technically demanding surgery is always done in combination with the indirect revascularization surgery.
Think of it like building a detour around a closed road: a small scalp artery is connected straight to a brain vessel, so blood can flow past the blockage right away.
Indirect revascularization surgery
Tissues in the vicinity of the brain such as the muscle (temporalis muscle), dura (covering membrane of the brain) and galea (scalp tissue) are surgically attached to the brain surface. New blood vessels sprout from these tissues to supply the oxygen-starved brain.
Like laying fresh turf so grass can root, healthy nearby tissue is rested on the brain. Over the following weeks it naturally grows new blood vessels down into the hungry brain.
Meet your doctors
Neurosurgeons with focused experience in Moyamoya, trained in India and Japan.
Senior Consultant Neurosurgeon
Yashoda Hospitals, Hyderabad
Professor Dr. B. Jayanand Sudhir has over 16 years of experience in Neurosurgery with over 14 years of experience in treating Moyamoya angiopathy. He has obtained training for brain bypass surgery from SCTIMST, Trivandrum, Hokkaido University Hospital and Teishinkai Hospital in Sapporo, Japan.
Dr. B. Jayanand Sudhir is currently Senior Consultant Neurosurgeon at Yashoda Hospitals, Hyderabad.
Associate Consultant
Neurosurgery
Dr. Vamshi Reddy P. completed his neurosurgical training at SCTIMST, Trivandrum, and currently serves as an Associate Consultant.
Where to find us
Questions, answered
Straight answers to the questions patients and families ask most.
Moyamoya disease is a rare and progressive disorder in which the major blood vessels supplying the brain gradually narrow or become blocked. This leads to reduced blood flow and increases the risk of stroke due to blockage of blood flow or bleeding in the brain.
Talk to us
Tell us what you have noticed. We will help you understand what to do next.
Consultations by appointment at Hyderabad, Trivandrum and Adilabad.
Please do not share scans, reports or sensitive medical details through this form. For clinical evaluation, book an in-person consultation.