Is Dizziness Normal After Moyamoya Surgery?

Understanding Post-Surgical Dizziness in Moyamoya Patients

It's not uncommon for patients to experience dizziness following surgery for moyamoya disease. This neurological condition, characterized by the narrowing of arteries in the brain, often requires surgical intervention to restore proper blood flow. After such procedures—such as direct or indirect revascularization—the brain undergoes significant adjustments in cerebral circulation. These hemodynamic changes can temporarily disrupt balance and sensory perception, leading to feelings of lightheadedness or even vertigo in some individuals.

Early Dizziness: A Common and Usually Temporary Side Effect

Dizziness that occurs shortly after surgery is typically considered a normal part of the recovery process. The brain needs time to adapt to improved blood flow, especially after long-standing ischemia. Additionally, anesthesia, postoperative medications, and prolonged bed rest can all contribute to temporary imbalance and disorientation. Most patients find that these symptoms gradually subside within days or weeks as their body adjusts and physical activity increases under medical guidance.

When Dizziness Warrants Medical Attention

While mild dizziness early on is expected, persistent or recurrent dizziness one month after discharge may indicate an underlying issue that requires evaluation. If symptoms return after initial stabilization, it's important to consult a neurologist or neurosurgeon. This could signal complications such as overperfusion syndrome, new vascular spasms, or unrelated conditions like inner ear disorders, low blood pressure, or medication side effects.

Potential Causes Beyond the Surgical Procedure

In many cases, post-surgical dizziness isn't directly caused by the brain surgery itself but rather by secondary factors. Extended bed rest during hospitalization can lead to deconditioning of the cardiovascular system. When patients resume standing and walking at home, orthostatic hypotension—sudden drops in blood pressure upon standing—may trigger lightheadedness. Dehydration, poor nutrition, or inadequate salt intake can further exacerbate this effect.

Strategies for Managing and Reducing Dizziness

Gradual mobilization is key to recovery. Patients are encouraged to begin light physical activity as recommended by their healthcare team, which helps retrain the body's circulatory and balance systems. Staying well-hydrated, maintaining balanced electrolytes, and eating regular, nutritious meals also support neurological and cardiovascular stability. Physical therapy may be beneficial for those with prolonged imbalance.

Long-Term Monitoring and Follow-Up Care

Ongoing follow-up with imaging studies such as MRI, MRA, or SPECT scans allows doctors to monitor cerebral blood flow and ensure the bypass grafts or collateral vessels are functioning properly. Any new or worsening neurological symptoms—including frequent dizziness—should prompt immediate medical review to rule out complications and optimize long-term outcomes.

Conclusion: Listen to Your Body and Seek Guidance

While occasional dizziness after moyamoya surgery is common and usually resolves on its own, recurring or severe symptoms should never be ignored. With proper medical supervision, lifestyle adjustments, and timely intervention, most patients achieve a smooth recovery and return to normal daily activities with improved brain health.