Recovery Timeline After Moyamoya Surgery: When Can Patients Be Discharged?

Understanding Moyamoya Disease and Surgical Treatment

Moyamoya disease is a rare, progressive cerebrovascular disorder that causes the narrowing or blockage of arteries in the brain, leading to reduced blood flow. To restore circulation and prevent strokes, patients typically undergo revascularization surgery. The two most common procedures are direct bypass (such as superficial temporal artery to middle cerebral artery anastomosis) and indirect revascularization techniques like encephaloduroarteriosynangiosis (EDAS), where blood vessels are either connected directly or placed on the brain surface to encourage new vessel growth.

Typical Hospital Stay After Surgery

Most patients can expect to be discharged within one week following moyamoya surgery, assuming there are no complications. While the surgical trauma itself is relatively minimal due to advanced microsurgical techniques, the procedure requires general anesthesia and precise manipulation of delicate brain structures. Therefore, a short hospital stay is essential for close monitoring and timely intervention if any issues arise.

Postoperative Monitoring and Recovery Process

After surgery, medical teams closely observe vital signs, neurological function, and potential signs of intracranial bleeding or infection—two of the primary risks associated with neurosurgical procedures. Although these complications are uncommon when performed by experienced surgeons, early detection is critical. Patients are typically kept in a monitored setting for 48 to 72 hours post-operation before transitioning to a regular ward.

Factors Influencing Discharge Timing

The decision to discharge depends on several factors, including the patient's overall health, surgical outcome, and absence of neurological deficits such as weakness, speech difficulties, or seizures. If imaging tests (like MRI or CT angiography) confirm successful revascularization and the patient is able to eat, walk, and perform basic activities independently, discharge is usually approved around the fifth to seventh day.

What Happens After Leaving the Hospital?

Once discharged, patients continue recovery at home under medical guidance. Doctors often recommend avoiding strenuous activity for several weeks, attending follow-up appointments, and sometimes taking antiplatelet medications to support blood flow. Physical therapy or occupational therapy may also be advised depending on individual progress.

Long-Term Outlook and Follow-Up Care

With proper care, many patients experience improved cerebral perfusion and a lower risk of stroke after surgery. Regular imaging follow-ups help assess the development of collateral circulation—the hallmark of successful treatment. Long-term prognosis is generally favorable, especially when surgery is performed early in the disease course.

In summary, while moyamoya surgery marks a significant step toward stabilizing brain blood flow, the journey doesn't end at discharge. A well-structured recovery plan ensures optimal outcomes and supports a safe return to daily life.