Moyamoya is a rare progressive cerebrovascular condition where arteries at the base of the brain narrow and close. The body responds by growing a tangled web of fragile collateral vessels that look like a puff of smoke on imaging. About 1 in 100,000 people in the US are affected.
Adults can present with ischemic events (TIAs, ischemic stroke), hemorrhagic stroke, severe sudden headache, cognitive decline, or seizures. About half of adult cases involve hemorrhage in Asian populations. Adults are roughly seven times more likely than children to bleed. Read our full symptoms guide for more.
Children almost always present with ischemic events: TIAs, completed strokes, seizures, or transient one-sided weakness. Symptoms are often triggered by hyperventilation, such as crying, vigorous exercise, or blowing on hot food. Cognitive delays and headaches are also common. See our paediatric symptoms section for detail.
The cause is not fully understood. The RNF213 gene is the principal susceptibility gene in East Asian populations, where the disease is around ten times more common than in the US. Moyamoya syndrome occurs alongside sickle cell disease, neurofibromatosis type 1, Down syndrome, prior cranial radiation, and certain autoimmune diseases.
The preferred initial workup is MRI plus MRA (magnetic resonance angiography). Digital subtraction angiography (DSA) is the gold-standard test and is used for surgical planning. Doctors classify the disease using the six-stage Suzuki staging system. Our treatment page covers diagnosis in more detail.
Surgical revascularisation is the only treatment with demonstrated long-term stroke reduction. The most common procedure is a direct bypass (STA-MCA), where a scalp artery is microsurgically connected to a brain artery, restoring immediate blood flow. Vince's eight-hour bypass was performed by Dr. Gary Steinberg at Stanford.
Direct bypass (STA-MCA) connects a scalp artery directly to a brain artery, giving immediate blood flow. Indirect bypass (EDAS, EMS, or pial synangiosis) lays vascularised tissue against the brain surface to coax new vessels to grow over weeks to months. Combined procedures use both.
Without surgery, recurrent stroke risk reaches around 40% at five years and higher in bilateral disease. After bypass at a high-volume centre such as Stanford, the published five-year stroke or death rate falls to around 5.5%. Surgery dramatically changes the outcome curve.
The underlying arterial narrowing is not reversed by surgery. The bypass restores blood flow, but moyamoya can progress in the other hemisphere or further down the affected side. Lifelong follow-up imaging is the norm. Most patients remain stable with appropriate monitoring and aspirin therapy.
About 62% of moyamoya patients are initially misdiagnosed, with an average 5.28 years from first symptom to correct diagnosis. Most clinicians never see a case. Common incorrect diagnoses are cerebral vasculitis (31%), ill-defined stroke (30%), and multiple sclerosis (4%). Awareness is the single highest-leverage intervention.
Yes. Walking is encouraged immediately. Strenuous exercise is typically paused for around 4 weeks post-op. After clearance, most patients have minimal long-term restrictions. Vince rode 10,000+ miles in the eight months after his bypass. Always follow your surgical team's specific guidance.
Most patients can return to recreational sport once cleared by their surgical team, usually within a few months. Return to elite or contact sport is more individual. Vince returned to professional MMA approximately one year after his bypass, representing the upper bound of return-to-elite-athletics.
Driving usually waits until the first follow-up appointment, typically a few weeks post-op. Patients who had a stroke before surgery may face longer driving restrictions per state law. Your neurology and surgical team will give specific guidance based on your recovery and any residual deficits.
Pregnancy in known moyamoya requires multidisciplinary planning across neurology, neurosurgery, and obstetrics. Risks include hypertensive complications, hemorrhagic stroke, and labour-related blood pressure changes. Most patients can carry pregnancies safely with planning, often delivering by caesarean to avoid Valsalva pressures. Talk to a moyamoya-experienced team early.
A rare-disease diagnosis is a real psychological event. Anxiety, fear of recurrence, and post-stroke depression are common and treatable. Therapy, peer support groups, and connecting with other survivors all help. If you are struggling, talk to your care team. You are not the first or only person to feel this way.
Many children with moyamoya can play sport with their surgical and neurology team's guidance. Activities that trigger hyperventilation (vigorous prolonged exertion, wind instruments) may need adjustment until after revascularisation. After surgery, return-to-play is decided individually based on imaging, hemodynamic reserve, and the specific activity.
You want a multidisciplinary team: a vascular neurologist, a cerebrovascular neurosurgeon experienced with moyamoya bypass, a neuroradiologist familiar with DSA and perfusion imaging, and ideally a centre that treats moyamoya regularly. Volume predicts outcomes. See our treatment centres directory for high-volume US options.
The Moyamoya Foundation, the World Moyamoya Alliance, CHASA (paediatric stroke families), the r/Moyamoya subreddit, and several Facebook groups all host active communities. Miles for Moyamoya is building a network for adult survivors and athletes. Reach out through our contact page to connect.
Vince Murdock is a professional MMA fighter (12-6-0 record, 9 wins by KO/TKO) who was diagnosed with moyamoya disease in 2019. He had an eight-hour brain bypass at Stanford by Dr. Gary Steinberg in November 2019 and returned to professional MMA approximately one year later. He founded Miles for Moyamoya.
Miles for Moyamoya is a nonprofit founded by Vince Murdock that raises awareness and funds for moyamoya disease research through endurance cycling, storytelling, and community building. Based in Sacramento. Currently $36,000+ raised toward a $100,000 research goal. Every mile fights for a cure.
Cycling was Vince's rehabilitation. He rode 10,000+ miles in the eight months after his bypass, and imaging later showed his bypass vessels had quadrupled in size. Cycling now connects his recovery to a fundraising engine and a community that values endurance, suffering, and showing up.
Miles for Moyamoya has raised $36,000+ toward a $100,000 research goal. Every dollar goes toward fighting moyamoya disease. Progress updates are shared on Instagram @milesformoyamoya. Follow along to see how the total grows and how funds are deployed.
Follow @milesformoyamoya on Instagram for fundraising progress, event announcements, and Vince's training and race updates. Vince's personal training and racing account is @vincemurdock. Subscribe through this site for occasional email updates as our community grows.
Use the contact form on this site. We respond within 48 hours. For media enquiries, see our press kit page (coming soon) for downloadable bios, logos, and a photo pack. For partnership and sponsorship enquiries, use the contact form and mention partnership in your message.
Donations fund moyamoya disease research, awareness campaigns, and patient support resources. We are working toward formal financial transparency reporting and Candid Seal certification as the organisation matures. Every dollar raised goes toward fighting moyamoya, not administrative overhead, wherever possible.
Tax-deductibility depends on the specific fundraising campaign and the entity handling the donation. Check each campaign page for details. We are working through the steps to ensure clean, formal nonprofit status documentation. For specific guidance, consult a tax professional.
Share Vince's story and these pages on social media; awareness is the highest-leverage action because moyamoya is so often missed. Follow @milesformoyamoya. Join a ride. Talk to your network. Sign up for updates. The fight is awareness as much as money.
Absolutely. We welcome community-organised events: rides, runs, bike challenges, anything that fits your community. Reach out through the contact form with your idea and we will help you plan, promote, and amplify it. Every event grows the community.
Yes. Corporate partnerships are open: ride sponsorships, awareness campaign co-branding, employee fundraising drives, in-kind support. Audiences include the cycling endurance community, the combat sport community, and the rare disease advocacy network. Reach out through the contact form and mention partnership.
Upcoming rides, races, and awareness events are announced on Instagram @milesformoyamoya and on our events page. Sacramento group rides and selected gravel and cyclocross races are the primary anchor events. Follow along to see when and where the next one is.
We respond to every message within 48 hours. Patients, families, journalists, partners, all welcome.