Moyamoya Disease

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Duke is a leading national referral center for moyamoya disease, a rare condition in which large arteries thicken and reduce the brain's blood supply. This can lead to cognitive impairment, stroke, mini-strokes (or transient ischemic attacks), aneurysm, or bleeding in the brain. Our neurosurgeons restore blood flow to relieve symptoms and reduce the risk of these serious complications.

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About Moyamoya Disease

Moyamoya is a potentially devastating, progressive condition that occurs when the walls of the brain's large arteries narrow and gradually shut down blood flow. To compensate, the brain creates smaller, weaker vessels to distribute blood. In X-ray images, these small vessels resemble a puff of smoke, which is translated as “moyamoya” in Japanese.

Our Locations

Duke Health offers locations throughout the Triangle. Find one near you.


CT and MRI Scans

High resolution, 3D images of the brain and its blood vessels are analyzed to look for potential narrowing or bulging in arteries. These can be performed with or without contrast dye. These tests usually last 30 to 60 minutes and are virtually painless. When MRI or CT scans are used to examine blood vessels (angiograms), they are called MRAs and CTAs.

Cerebral Angiography

Through a small incision, a catheter is inserted into a large artery and threaded through the circulatory system to the brain. A contrast dye is injected; this shows neuroradiologists -- specialists in the nerves found in the brain and spine -- areas of concern. This test takes about an hour and requires you to lie flat afterward for two to four hours

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Drugs may be prescribed to reduce the risk of blood clots or stroke and to control symptoms like seizures.

Cerebral Artery Bypass

Through an open incision in the skull, called a craniotomy, neurosurgeons reroute blood flow around the blocked artery using a replacement blood vessel from another part of your body. The new artery bypasses the damaged blood vessels and restores healthy blood flow in the brain.


In rare cases, you may need surgery to repair a damaged artery. We use the most advanced and least invasive techniques possible to ensure you receive the most effective treatment.

Best Hospital for Neurology, Neurosurgery in NC

Where you receive your care matters. Duke University Hospital is proud of our team and the exceptional care they provide. They are why our neurology and neurosurgery program is nationally ranked, and the highest-ranked program in North Carolina by U.S. News & World Report for 2023–2024.

Why Choose Duke

Emergency Diagnosis and Response
Many cerebrovascular diseases aren’t diagnosed until after a serious complication occurs. Our team is the region's leading resource for brain health emergencies, including aneurysms and strokes. Speed of treatment is critical for recovery, and our policies and processes for stroke care have been recognized by The Joint Commission.

Advanced Training and Surgical Experience
Our highly specialized physicians and surgeons have completed additional years of training for moyamoya disease treatment and are experts in their fields. Our neurosurgeons’ experience treating this complex, sometimes life-threatening condition on a regular basis increases the chance of successful outcomes. 

Leading Referral Center
Our outcomes have solidified our reputation as a referral center for confirming diagnoses, consulting on complex cases, and caring for patients who have been turned away elsewhere for moyamoya treatment.

A Team Approach
Our medical team includes highly trained specialists such as:

  • Specially trained radiologists who capture and interpret images of blood vessels in your brain
  • Neurologists who are experts in treating brain disorders
  • Neurosurgeons who regularly perform procedures to reduce or eliminate cerebrovascular disturbances

We work together to create the treatment plan that's best for you.

Diagnostic and Imaging Expertise
We use the latest diagnostic and imaging technologies quickly and effectively. These tools enhance our ability to review your medical situation and present the safest and best treatment options.

This page was medically reviewed on 04/25/2022 by