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<meta name="DC.Title" content="Cerebrovascular Collaterals Correlate with Disease Severity in Adult North American Patients with Moyamoya Disease" />
<meta name="DC.Identifier" content="10.3174/ajnr.A3883" />
<meta name="DC.Date" content="2014-03-20" />
<meta name="DC.Publisher" content="American Journal of Neuroradiology" />
<meta name="DC.Rights" content="© 2014 American Society of Neuroradiology. Indicates open access to non-subscribers at www.ajnr.org" />
<meta name="DC.AccessRights" content="open-access" />
<meta name="DC.Description" content="BACKGROUND AND PURPOSE: Cerebrovascular collaterals have been increasingly recognized as predictive of clinical outcomes in Moyamoya disease in Asia. The aim of this study was to characterize collaterals in North American adult patients with Moyamoya disease and to assess whether similar correlations are valid.

MATERIALS AND METHODS: Patients with Moyamoya disease ( n = 39; mean age, 43.5 ±10.6 years) and age- and sex-matched control subjects ( n = 33; mean age, 44.3 ± 12.0 years) were graded via angiography. Clinical symptoms of stroke or hemorrhage were graded separately by imaging. Correlations between collateralization and disease severity, measured by the modified Suzuki score, were evaluated in patients with Moyamoya disease by fitting a regression model with clustered ordinal multinomial responses.

RESULTS: The presence of leptomeningeal collaterals ( P = .008), dilation of the anterior choroidal artery ( P = .01), and the posterior communicating artery/ICA ratio ( P = .004) all correlated significantly with disease severity. The presence of infarct or hemorrhage and posterior steno-occlusive disease did not correlate significantly with the modified Suzuki score ( P = .1). Anterior choroidal artery changes were not specific for hemorrhage. Patients with Moyamoya disease were statistically more likely than controls to have higher posterior communicating artery/ICA ratios and a greater incidence of leptomeningeal collaterals.

CONCLUSIONS: As with Moyamoya disease in Asian patients, the presence of cerebrovascular collaterals correlated with the modified Suzuki score for disease severity in North American patients with Moyamoya disease. However, anterior choroidal artery changes, which correlated with increased rates of hemorrhage in Asian studies, were not specific to hemorrhage in North Americans.

### Abbreviations

AchoA
:   anterior choroidal artery
LMC
:   leptomeningeal collaterals
MMD
:   Moyamoya disease
mSS
:   modified Suzuki score
P1
:   proximal segment of the posterior cerebral artery
PCA
:   posterior cerebral artery
PcomA
:   posterior communicating artery" />
<meta name="DC.Contributor" content="M.K. Strother" />
<meta name="DC.Contributor" content="M.D. Anderson" />
<meta name="DC.Contributor" content="R.J. Singer" />
<meta name="DC.Contributor" content="L. Du" />
<meta name="DC.Contributor" content="R.D. Moore" />
<meta name="DC.Contributor" content="Y. Shyr" />
<meta name="DC.Contributor" content="T.R. Ladner" />
<meta name="DC.Contributor" content="D. Arteaga" />
<meta name="DC.Contributor" content="M.A. Day" />
<meta name="DC.Contributor" content="P.F. Clemmons" />
<meta name="DC.Contributor" content="M.J. Donahue" />
<meta name="article:published_time" content="2014-03-20" />
<meta name="article:section" content="BRAIN" />
<meta name="citation_title" content="Cerebrovascular Collaterals Correlate with Disease Severity in Adult North American Patients with Moyamoya Disease" />
<meta name="citation_abstract" lang="en" content="&lt;h3&gt;BACKGROUND AND PURPOSE:&lt;/h3&gt;
&lt;p&gt;Cerebrovascular collaterals have been increasingly recognized as predictive of clinical outcomes in Moyamoya disease in Asia. The aim of this study was to characterize collaterals in North American adult patients with Moyamoya disease and to assess whether similar correlations are valid.&lt;/p&gt;&lt;h3&gt;MATERIALS AND METHODS:&lt;/h3&gt;
&lt;p&gt;Patients with Moyamoya disease (&lt;i&gt;n&lt;/i&gt; = 39; mean age, 43.5 ±10.6 years) and age- and sex-matched control subjects (&lt;i&gt;n&lt;/i&gt; = 33; mean age, 44.3 ± 12.0 years) were graded via angiography. Clinical symptoms of stroke or hemorrhage were graded separately by imaging. Correlations between collateralization and disease severity, measured by the modified Suzuki score, were evaluated in patients with Moyamoya disease by fitting a regression model with clustered ordinal multinomial responses.&lt;/p&gt;&lt;h3&gt;RESULTS:&lt;/h3&gt;
&lt;p&gt;The presence of leptomeningeal collaterals (&lt;i&gt;P&lt;/i&gt; = .008), dilation of the anterior choroidal artery (&lt;i&gt;P&lt;/i&gt; = .01), and the posterior communicating artery/ICA ratio (&lt;i&gt;P&lt;/i&gt; = .004) all correlated significantly with disease severity. The presence of infarct or hemorrhage and posterior steno-occlusive disease did not correlate significantly with the modified Suzuki score (&lt;i&gt;P&lt;/i&gt; = .1). Anterior choroidal artery changes were not specific for hemorrhage. Patients with Moyamoya disease were statistically more likely than controls to have higher posterior communicating artery/ICA ratios and a greater incidence of leptomeningeal collaterals.&lt;/p&gt;&lt;h3&gt;CONCLUSIONS:&lt;/h3&gt;
&lt;p&gt;As with Moyamoya disease in Asian patients, the presence of cerebrovascular collaterals correlated with the modified Suzuki score for disease severity in North American patients with Moyamoya disease. However, anterior choroidal artery changes, which correlated with increased rates of hemorrhage in Asian studies, were not specific to hemorrhage in North Americans.&lt;/p&gt;" />
<meta name="citation_journal_title" content="American Journal of Neuroradiology" />
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<meta name="citation_publication_date" content="2014/03/20" />
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<meta name="citation_author" content="M.K. Strother" />
<meta name="citation_author_institution" content="From the Departments of Radiology and Radiological Sciences (M.K.S., M.D.A., R.D.M., T.R.L., D.A., M.A.D., P.F.C., M.J.D.), Neurology (M.J.D.), Psychiatry (M.J.D), and Physics and Astronomy (M.J.D.), and Vanderbilt Center for Quantitative Sciences (L.D., Y.S.); Vanderbilt University School of Medicine, Nashville, Tennessee; and Section of Neurosurgery (R.J.S.), Dartmouth-Hitchcock Medical Center, Lebanon, New Hampshire." />
<meta name="citation_author" content="M.D. Anderson" />
<meta name="citation_author_institution" content="From the Departments of Radiology and Radiological Sciences (M.K.S., M.D.A., R.D.M., T.R.L., D.A., M.A.D., P.F.C., M.J.D.), Neurology (M.J.D.), Psychiatry (M.J.D), and Physics and Astronomy (M.J.D.), and Vanderbilt Center for Quantitative Sciences (L.D., Y.S.); Vanderbilt University School of Medicine, Nashville, Tennessee; and Section of Neurosurgery (R.J.S.), Dartmouth-Hitchcock Medical Center, Lebanon, New Hampshire." />
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<meta name="citation_author_institution" content="From the Departments of Radiology and Radiological Sciences (M.K.S., M.D.A., R.D.M., T.R.L., D.A., M.A.D., P.F.C., M.J.D.), Neurology (M.J.D.), Psychiatry (M.J.D), and Physics and Astronomy (M.J.D.), and Vanderbilt Center for Quantitative Sciences (L.D., Y.S.); Vanderbilt University School of Medicine, Nashville, Tennessee; and Section of Neurosurgery (R.J.S.), Dartmouth-Hitchcock Medical Center, Lebanon, New Hampshire." />
<meta name="citation_author" content="L. Du" />
<meta name="citation_author_institution" content="From the Departments of Radiology and Radiological Sciences (M.K.S., M.D.A., R.D.M., T.R.L., D.A., M.A.D., P.F.C., M.J.D.), Neurology (M.J.D.), Psychiatry (M.J.D), and Physics and Astronomy (M.J.D.), and Vanderbilt Center for Quantitative Sciences (L.D., Y.S.); Vanderbilt University School of Medicine, Nashville, Tennessee; and Section of Neurosurgery (R.J.S.), Dartmouth-Hitchcock Medical Center, Lebanon, New Hampshire." />
<meta name="citation_author" content="R.D. Moore" />
<meta name="citation_author_institution" content="From the Departments of Radiology and Radiological Sciences (M.K.S., M.D.A., R.D.M., T.R.L., D.A., M.A.D., P.F.C., M.J.D.), Neurology (M.J.D.), Psychiatry (M.J.D), and Physics and Astronomy (M.J.D.), and Vanderbilt Center for Quantitative Sciences (L.D., Y.S.); Vanderbilt University School of Medicine, Nashville, Tennessee; and Section of Neurosurgery (R.J.S.), Dartmouth-Hitchcock Medical Center, Lebanon, New Hampshire." />
<meta name="citation_author" content="Y. Shyr" />
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<meta name="citation_author" content="T.R. Ladner" />
<meta name="citation_author_institution" content="From the Departments of Radiology and Radiological Sciences (M.K.S., M.D.A., R.D.M., T.R.L., D.A., M.A.D., P.F.C., M.J.D.), Neurology (M.J.D.), Psychiatry (M.J.D), and Physics and Astronomy (M.J.D.), and Vanderbilt Center for Quantitative Sciences (L.D., Y.S.); Vanderbilt University School of Medicine, Nashville, Tennessee; and Section of Neurosurgery (R.J.S.), Dartmouth-Hitchcock Medical Center, Lebanon, New Hampshire." />
<meta name="citation_author" content="D. Arteaga" />
<meta name="citation_author_institution" content="From the Departments of Radiology and Radiological Sciences (M.K.S., M.D.A., R.D.M., T.R.L., D.A., M.A.D., P.F.C., M.J.D.), Neurology (M.J.D.), Psychiatry (M.J.D), and Physics and Astronomy (M.J.D.), and Vanderbilt Center for Quantitative Sciences (L.D., Y.S.); Vanderbilt University School of Medicine, Nashville, Tennessee; and Section of Neurosurgery (R.J.S.), Dartmouth-Hitchcock Medical Center, Lebanon, New Hampshire." />
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<meta name="citation_author" content="M.J. Donahue" />
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<meta name="twitter:title" content="Cerebrovascular Collaterals Correlate with Disease Severity in Adult North American Patients with Moyamoya Disease" />
<meta name="twitter:card" content="summary" />
<meta name="twitter:description" content="BACKGROUND AND PURPOSE: Cerebrovascular collaterals have been increasingly recognized as predictive of clinical outcomes in Moyamoya disease in Asia. The aim of this study was to characterize collaterals in North American adult patients with Moyamoya disease and to assess whether similar correlations are valid.

MATERIALS AND METHODS: Patients with Moyamoya disease ( n = 39; mean age, 43.5 ±10.6 years) and age- and sex-matched control subjects ( n = 33; mean age, 44.3 ± 12.0 years) were graded via angiography. Clinical symptoms of stroke or hemorrhage were graded separately by imaging. Correlations between collateralization and disease severity, measured by the modified Suzuki score, were evaluated in patients with Moyamoya disease by fitting a regression model with clustered ordinal multinomial responses.

RESULTS: The presence of leptomeningeal collaterals ( P = .008), dilation of the anterior choroidal artery ( P = .01), and the posterior communicating artery/ICA ratio ( P = .004) all correlated significantly with disease severity. The presence of infarct or hemorrhage and posterior steno-occlusive disease did not correlate significantly with the modified Suzuki score ( P = .1). Anterior choroidal artery changes were not specific for hemorrhage. Patients with Moyamoya disease were statistically more likely than controls to have higher posterior communicating artery/ICA ratios and a greater incidence of leptomeningeal collaterals.

CONCLUSIONS: As with Moyamoya disease in Asian patients, the presence of cerebrovascular collaterals correlated with the modified Suzuki score for disease severity in North American patients with Moyamoya disease. However, anterior choroidal artery changes, which correlated with increased rates of hemorrhage in Asian studies, were not specific to hemorrhage in North Americans.

### Abbreviations

AchoA
:   anterior choroidal artery
LMC
:   leptomeningeal collaterals
MMD
:   Moyamoya disease
mSS
:   modified Suzuki score
P1
:   proximal segment of the posterior cerebral artery
PCA
:   posterior cerebral artery
PcomA
:   posterior communicating artery" />
<meta name="og-title" property="og:title" content="Cerebrovascular Collaterals Correlate with Disease Severity in Adult North American Patients with Moyamoya Disease" />
<meta name="og-url" property="og:url" content="http://ajnr-stage2.stage.highwire.org/content/early/2014/03/20/ajnr.A3883" />
<meta name="og-site-name" property="og:site_name" content="American Journal of Neuroradiology" />
<meta name="og-description" property="og:description" content="BACKGROUND AND PURPOSE: Cerebrovascular collaterals have been increasingly recognized as predictive of clinical outcomes in Moyamoya disease in Asia. The aim of this study was to characterize collaterals in North American adult patients with Moyamoya disease and to assess whether similar correlations are valid.

MATERIALS AND METHODS: Patients with Moyamoya disease ( n = 39; mean age, 43.5 ±10.6 years) and age- and sex-matched control subjects ( n = 33; mean age, 44.3 ± 12.0 years) were graded via angiography. Clinical symptoms of stroke or hemorrhage were graded separately by imaging. Correlations between collateralization and disease severity, measured by the modified Suzuki score, were evaluated in patients with Moyamoya disease by fitting a regression model with clustered ordinal multinomial responses.

RESULTS: The presence of leptomeningeal collaterals ( P = .008), dilation of the anterior choroidal artery ( P = .01), and the posterior communicating artery/ICA ratio ( P = .004) all correlated significantly with disease severity. The presence of infarct or hemorrhage and posterior steno-occlusive disease did not correlate significantly with the modified Suzuki score ( P = .1). Anterior choroidal artery changes were not specific for hemorrhage. Patients with Moyamoya disease were statistically more likely than controls to have higher posterior communicating artery/ICA ratios and a greater incidence of leptomeningeal collaterals.

CONCLUSIONS: As with Moyamoya disease in Asian patients, the presence of cerebrovascular collaterals correlated with the modified Suzuki score for disease severity in North American patients with Moyamoya disease. However, anterior choroidal artery changes, which correlated with increased rates of hemorrhage in Asian studies, were not specific to hemorrhage in North Americans.

### Abbreviations

AchoA
:   anterior choroidal artery
LMC
:   leptomeningeal collaterals
MMD
:   Moyamoya disease
mSS
:   modified Suzuki score
P1
:   proximal segment of the posterior cerebral artery
PCA
:   posterior cerebral artery
PcomA
:   posterior communicating artery" />
<meta name="og-type" property="og:type" content="article" />
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    <div class="highwire-article-citation highwire-citation-type-highwire-article node50575--5" data-node-nid="50575" id="top-node-50575--6765499720" data-pisa="ajnr;ajnr.A3883v1" data-pisa-master="ajnr;ajnr.A3883" data-apath="/ajnr/early/2014/03/20/ajnr.A3883.atom" data-hw-author-tooltip-instance="highwire_author_tooltip"><div class="highwire-cite highwire-cite-highwire-article highwire-citation-jcore-article-title-complete clearfix has-author-tooltip highwire-citation-highwire-article-top-a">
  
  
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      <h1 class="highwire-cite-title" id="page-title">Cerebrovascular Collaterals Correlate with Disease Severity in Adult North American Patients with Moyamoya Disease</h1>  
    	<div class="highwire-cite-authors"><span  class="highwire-citation-authors"><span class="highwire-citation-author first" data-delta="0">M.K. Strother</span>, <span class="highwire-citation-author" data-delta="1">M.D. Anderson</span>, <span class="highwire-citation-author" data-delta="2">R.J. Singer</span>, <span class="highwire-citation-author" data-delta="3">L. Du</span>, <span class="highwire-citation-author" data-delta="4">R.D. Moore</span>, <span class="highwire-citation-author" data-delta="5">Y. Shyr</span>, <span class="highwire-citation-author" data-delta="6">T.R. Ladner</span>, <span class="highwire-citation-author" data-delta="7">D. Arteaga</span>, <span class="highwire-citation-author" data-delta="8">M.A. Day</span>, <span class="highwire-citation-author" data-delta="9">P.F. Clemmons</span> and <span class="highwire-citation-author" data-delta="10">M.J. Donahue</span></span></div>
  
    	<div class="highwire-cite-metadata"><span  class="highwire-cite-metadata-journal highwire-cite-metadata">American Journal of Neuroradiology </span><span  class="highwire-cite-metadata-date highwire-cite-metadata">March 2014,  </span><span  class="highwire-cite-metadata-doi highwire-cite-metadata">DOI: https://doi.org/10.3174/ajnr.A3883 </span></div>
  
  
  
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<div id="hw-article-author-popups-top-node-50575--6765499720" style="display: none;"><div class="author-tooltip-0"><div class="author-tooltip-name">M.K. Strother </div><div class="author-tooltip-affiliation"><span class="author-tooltip-text"><div class='author-affiliation'>From the Departments of Radiology and Radiological Sciences (M.K.S., M.D.A., R.D.M., T.R.L., D.A., M.A.D., P.F.C., M.J.D.), Neurology (M.J.D.), Psychiatry (M.J.D), and Physics and Astronomy (M.J.D.), and Vanderbilt Center for Quantitative Sciences (L.D., Y.S.); Vanderbilt University School of Medicine, Nashville, Tennessee; and Section of Neurosurgery (R.J.S.), Dartmouth-Hitchcock Medical Center, Lebanon, New Hampshire.</div></span></div><ul class="author-tooltip-find-more"><li class="author-tooltip-gs-link first"><a href="/lookup/google-scholar?link_type=googlescholar&amp;gs_type=author&amp;author%5B0%5D=M.K.%2BStrother%2B" target="_blank" class="" data-icon-position="" data-hide-link-title="0">Find this author on Google Scholar</a></li><li class="author-tooltip-pubmed-link"><a href="/lookup/external-ref?access_num=Strother%20M&amp;link_type=AUTHORSEARCH" target="_blank" class="" data-icon-position="" data-hide-link-title="0">Find this author on PubMed</a></li><li class="author-site-search-link last"><a href="/search/author1%3AM.K.%2BStrother%2B" rel="nofollow" class="" data-icon-position="" data-hide-link-title="0">Search for this author on this site</a></li></ul></div><div class="author-tooltip-1"><div class="author-tooltip-name">M.D. Anderson </div><div class="author-tooltip-affiliation"><span class="author-tooltip-text"><div class='author-affiliation'>From the Departments of Radiology and Radiological Sciences (M.K.S., M.D.A., R.D.M., T.R.L., D.A., M.A.D., P.F.C., M.J.D.), Neurology (M.J.D.), Psychiatry (M.J.D), and Physics and Astronomy (M.J.D.), and Vanderbilt Center for Quantitative Sciences (L.D., Y.S.); Vanderbilt University School of Medicine, Nashville, Tennessee; and Section of Neurosurgery (R.J.S.), Dartmouth-Hitchcock Medical Center, Lebanon, New Hampshire.</div></span></div><ul class="author-tooltip-find-more"><li class="author-tooltip-gs-link first"><a href="/lookup/google-scholar?link_type=googlescholar&amp;gs_type=author&amp;author%5B0%5D=M.D.%2BAnderson%2B" target="_blank" class="" data-icon-position="" data-hide-link-title="0">Find this author on Google Scholar</a></li><li class="author-tooltip-pubmed-link"><a href="/lookup/external-ref?access_num=Anderson%20M&amp;link_type=AUTHORSEARCH" target="_blank" class="" data-icon-position="" data-hide-link-title="0">Find this author on PubMed</a></li><li class="author-site-search-link last"><a href="/search/author1%3AM.D.%2BAnderson%2B" rel="nofollow" class="" data-icon-position="" data-hide-link-title="0">Search for this author on this site</a></li></ul></div><div class="author-tooltip-2"><div class="author-tooltip-name">R.J. Singer </div><div class="author-tooltip-affiliation"><span class="author-tooltip-text"><div class='author-affiliation'>From the Departments of Radiology and Radiological Sciences (M.K.S., M.D.A., R.D.M., T.R.L., D.A., M.A.D., P.F.C., M.J.D.), Neurology (M.J.D.), Psychiatry (M.J.D), and Physics and Astronomy (M.J.D.), and Vanderbilt Center for Quantitative Sciences (L.D., Y.S.); Vanderbilt University School of Medicine, Nashville, Tennessee; and Section of Neurosurgery (R.J.S.), Dartmouth-Hitchcock Medical Center, Lebanon, New Hampshire.</div></span></div><ul class="author-tooltip-find-more"><li class="author-tooltip-gs-link first"><a href="/lookup/google-scholar?link_type=googlescholar&amp;gs_type=author&amp;author%5B0%5D=R.J.%2BSinger%2B" target="_blank" class="" data-icon-position="" data-hide-link-title="0">Find this author on Google Scholar</a></li><li class="author-tooltip-pubmed-link"><a href="/lookup/external-ref?access_num=Singer%20R&amp;link_type=AUTHORSEARCH" target="_blank" class="" data-icon-position="" data-hide-link-title="0">Find this author on PubMed</a></li><li class="author-site-search-link last"><a href="/search/author1%3AR.J.%2BSinger%2B" rel="nofollow" class="" data-icon-position="" data-hide-link-title="0">Search for this author on this site</a></li></ul></div><div class="author-tooltip-3"><div class="author-tooltip-name">L. Du </div><div class="author-tooltip-affiliation"><span class="author-tooltip-text"><div class='author-affiliation'>From the Departments of Radiology and Radiological Sciences (M.K.S., M.D.A., R.D.M., T.R.L., D.A., M.A.D., P.F.C., M.J.D.), Neurology (M.J.D.), Psychiatry (M.J.D), and Physics and Astronomy (M.J.D.), and Vanderbilt Center for Quantitative Sciences (L.D., Y.S.); Vanderbilt University School of Medicine, Nashville, Tennessee; and Section of Neurosurgery (R.J.S.), Dartmouth-Hitchcock Medical Center, Lebanon, New Hampshire.</div></span></div><ul class="author-tooltip-find-more"><li class="author-tooltip-gs-link first"><a href="/lookup/google-scholar?link_type=googlescholar&amp;gs_type=author&amp;author%5B0%5D=L.%2BDu%2B" target="_blank" class="" data-icon-position="" data-hide-link-title="0">Find this author on Google Scholar</a></li><li class="author-tooltip-pubmed-link"><a href="/lookup/external-ref?access_num=Du%20L&amp;link_type=AUTHORSEARCH" target="_blank" class="" data-icon-position="" data-hide-link-title="0">Find this author on PubMed</a></li><li class="author-site-search-link last"><a href="/search/author1%3AL.%2BDu%2B" rel="nofollow" class="" data-icon-position="" data-hide-link-title="0">Search for this author on this site</a></li></ul></div><div class="author-tooltip-4"><div class="author-tooltip-name">R.D. 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<p id="p-2"><strong>BACKGROUND AND PURPOSE:</strong> Cerebrovascular collaterals have been increasingly recognized as predictive of clinical outcomes in Moyamoya disease in Asia. The aim of this study was to characterize collaterals in North American adult patients with Moyamoya disease and to assess whether similar correlations are valid.</p></div>
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<p id="p-3"><strong>MATERIALS AND METHODS:</strong> Patients with Moyamoya disease (<em>n</em> = 39; mean age, 43.5 ±10.6 years) and age- and sex-matched control subjects (<em>n</em> = 33; mean age, 44.3 ± 12.0 years) were graded via angiography. Clinical symptoms of stroke or hemorrhage were graded separately by imaging. Correlations between collateralization and disease severity, measured by the modified Suzuki score, were evaluated in patients with Moyamoya disease by fitting a regression model with clustered ordinal multinomial responses.</p></div>
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<p id="p-4"><strong>RESULTS:</strong> The presence of leptomeningeal collaterals (<em>P</em> = .008), dilation of the anterior choroidal artery (<em>P</em> = .01), and the posterior communicating artery/ICA ratio (<em>P</em> = .004) all correlated significantly with disease severity. The presence of infarct or hemorrhage and posterior steno-occlusive disease did not correlate significantly with the modified Suzuki score (<em>P</em> = .1). Anterior choroidal artery changes were not specific for hemorrhage. Patients with Moyamoya disease were statistically more likely than controls to have higher posterior communicating artery/ICA ratios and a greater incidence of leptomeningeal collaterals.</p></div>
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<p id="p-5"><strong>CONCLUSIONS:</strong> As with Moyamoya disease in Asian patients, the presence of cerebrovascular collaterals correlated with the modified Suzuki score for disease severity in North American patients with Moyamoya disease. However, anterior choroidal artery changes, which correlated with increased rates of hemorrhage in Asian studies, were not specific to hemorrhage in North Americans.</p>
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<h3>Abbreviations</h3>
<dl id="def-list-1"><dt id="def-item-1">AchoA<span class="def-item-dt-sep"></span></dt><dd>anterior choroidal artery<span class="def-item-dd-sep"></span></dd><dt id="def-item-2">LMC<span class="def-item-dt-sep"></span></dt><dd>leptomeningeal collaterals<span class="def-item-dd-sep"></span></dd><dt id="def-item-3">MMD<span class="def-item-dt-sep"></span></dt><dd>Moyamoya disease<span class="def-item-dd-sep"></span></dd><dt id="def-item-4">mSS<span class="def-item-dt-sep"></span></dt><dd>modified Suzuki score<span class="def-item-dd-sep"></span></dd><dt id="def-item-5">P1<span class="def-item-dt-sep"></span></dt><dd>proximal segment of the posterior cerebral artery<span class="def-item-dd-sep"></span></dd><dt id="def-item-6">PCA<span class="def-item-dt-sep"></span></dt><dd>posterior cerebral artery<span class="def-item-dd-sep"></span></dd><dt id="def-item-7">PcomA<span class="def-item-dt-sep"></span></dt><dd>posterior communicating artery</dd></dl>
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      <div class="highwire-cite-title">Cerebrovascular Collaterals Correlate with Disease Severity in Adult North American Patients with Moyamoya Disease</div>  
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