Cognitive Function in Pediatric Moyamoya Disease

Since the very early stage of moyamoya disease discovery, it has been known that cerebral infarction can cause cognitive dysfunction in children with moyamoya disease. In recent years, there are fewer children who develop cerebral infarction after a long period of repeated TIAs through the improved ability to diagnose moyamoya disease at an early stage. However, infants often have sudden onset of ischemic stroke, and the sequelae of cognitive dysfunction as well as motor dysfunction are still an issue that cannot be completely resolved. In this chapter, the author will review the pathophysiology of cognitive dysfunction in pediatric patients with moyamoya disease, their radiological findings, and effective surgical revascularization. The author strongly believes that early diagnosis and surgical revascularization should be performed before they still repeat TIAs or headache attacks and have not progressed to a completed stroke in order to improve the intellectual prognosis of pediatric patients with moyamoya disease. In addition, we should plan to perform surgical revascularization through “large” craniotomy covering the frontal lobes for this purpose.