Higher volume hospitals have better outcomes: Dr. Smith and his colleagues published an analysis of 2,454 admissions of pediatric moyamoya patients across the U.S. in the largest study of its kind. The results show that higher volume centers provide improved care and reduced mortality.
Evaluating possible growth factors in blood, cerebrospinal fluid, and urine: Dr. Smith and his colleagues are studying molecular compounds and growth factors in blood and in cerebrospinal fluid. They believe that these growth factors may yield crucial insights into the causes and progression of moyamoya, and may lead to therapies not only for that disorder, but also for cancer and other conditions involving the proliferation of blood vessels.
Considering possible nonsurgical treatments for moyamoya: Dr. Smith is also working to determine whether new drug therapies may provide a reasonable alternative to surgery for children with moyamoya.
Identifying biological warning signs for moyamoya: Our researchers are working to identify telltale proteins in blood and urine that could serve as early warning signals for the presence of disease by developing a urinary biomarker panel.
Understanding the role of certain proteins in moyamoya and other disorders: Dr. Smith is investigating whether specific molecules may be culpable in the onset of several diseases of the central nervous system, including moyamoya, brain tumors, and vascular malformations of the brain.
Selected papers
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An illustrated, instructional video demonstration in a 5-year-old child shows that pial synangiosis can be successfully applied to moyamoya affecting the posterior circulation.
A review of 34 procedures over a period of 12 years finds that the majority of children who have pial synangiosis for moyamoya before age 2 have a good long-term prognosis.
A review of 66 procedures from 1985 to 2010 finds pial synangiosis to be a safe and effective way to provide more blood to the brain in adults with moyamoya.
Data on 418 patients who underwent surgical revascularization demonstrate that moyamoya is a progressive disorder, even when it does not cause symptoms, and supports the use of early surgical intervention to minimize morbidity from stroke.
In this series of 12 patients with sickle-cell disease and moyamoya, 11 of whom had a prior stroke, pial synangiosis appears to be safe and confers long-lasting protection against further stroke.
