Moyamoya disease affects the arteries that carry blood to the brain. As those vessels narrow or become blocked, the body develops small collateral vessels in an effort to maintain circulation. On brain imaging, that network can resemble a cloud or a puff of smoke—the meaning of “moyamoya” in Japanese—according to UCSF Health.
Recognizing the condition
Reduced blood flow can produce headaches, seizures, weakness or numbness, cognitive or sensory problems, and transient ischemic attacks or strokes. The replacement vessels are fragile and can also bleed, which is why symptoms that appear to be ordinary headaches can require neurological evaluation, according to UCSF Health. The disease is more common in East Asia and has diagnostic peaks in childhood and adulthood, with adults generally falling in the 30-to-50 age range, according to Washington University in St. Louis and the National Organization for Rare Disorders.
Diagnosis and treatment
Doctors use vascular imaging to look for narrowed arteries and the abnormal collateral network. Treatment is intended to improve blood flow and lower the chance of future strokes. In direct revascularization, a surgeon connects an artery from the scalp to an artery supplying the brain; indirect procedures instead encourage new vessels to develop over time, according to Stanford Health Care. Medication may also be used in some cases, but patients require continuing medical monitoring, according to UCSF Health.
What research shows about rarity and risk
U.S. estimates remain limited because available research does not come from a nationwide registry. According to a PubMed-indexed study using hospital and ambulatory-care data from four states, researchers identified 4,192 incident cases of moyamoya angiopathy from 2011 to 2020. In that study, incidence was approximately twice as high in women as in men and was higher among Asian and Black individuals than among non-Hispanic White individuals. Moyamoya disease is distinct from Wisconsin’s broader stroke burden. Wisconsin Department of Health Services data show that about seven out of 10 of the state’s 2017 hospitalizations with stroke as the principal diagnosis occurred among people over age 65, according to the Wisconsin Department of Health Services.
Why Wisconsin appears in one patient’s treatment story
One patient account illustrates the diagnostic and treatment challenges without representing every case. CBS 58 reported that Milwaukee resident Alysha Botsford, who was 35, experienced a stroke in April 2024 after a long history of symptoms treated as migraines; subsequent testing identified Moyamoya disease. The outlet also reported that she underwent two revascularization operations, later suffered another stroke related to a fragile vessel, and required a third operation. WisBusiness separately reported the same treatment course and identified UW Health neurosurgeon Mustafa Baskaya as her surgeon. These patient-specific details come from those two outlets, not from independent interviews for this article.
The Wisconsin connection was specific to Botsford’s care: Baskaya performs cerebrovascular procedures, including surgery for Moyamoya disease, at UW Health. His university profile lists him as a professor of neurological surgery and director of the Skull Base Surgery Program; Madison.com reported that only a small number of U.S. surgeons perform the relevant direct bypass procedures, including specialists in California, Minnesota, and Wisconsin. The medical background above is based on institutional sources, while the account of Botsford’s diagnosis and recovery remains attributed to CBS 58 and WisBusiness.
