Middle East J Rehabil Health. In press(In press):e45318. Published online 2017 February 28. doi: 10.5812/mejrh.45318. Brief Report Description of a Cohort of Patients with the Moyamoya Syndrome in a Rehabilitation Hospital Vinicius Viana Abreu Montanaro, 1,* and Thiago Falcao Hora 1 1 SARAH Network of Rehabilitation Hospitals, Brasilia, Brazil * Corresponding author: Vinicius Viana Abreu Montanaro, SARAH Hospital, SMHS 501, Bl A, Brasilia, Brazil. Tel: +55-6133191555, E-mail: vinicius_montanaro@yahoo.com.br Received 2017 January 03; Revised 2017 February 05; Accepted 2017 February 07. Abstract Background: Moyamoya disease (MMD) is a chronic steno-occlusive cerebrovascular condition initially described in 1957 in a Japanese patient. The classic angiographic findings include bilateral stenosis or occlusion at the terminal portion of the internal carotid artery, with an abnormal vascular network at the base of the brain. There are few epidemiological descriptions of non-Asian cases. Objectives: This study aimed at evaluating a cohort of patients with the MMD admitted in a quaternary, open-access rehabilitation hospital in central Brazil. Methods: This was a retrospective, observational study. Two neurologists reviewed data from electronic records of patients with MMD admitted to SARAH Hospital in Brasilia in the past sixteen years. Data on etiology, associated conditions and general charac- teristics were collected. The modified Rankim scale (mRS) was used to determine morbidity. Results: Twenty-one patients were identified and selected for this research. The average age at presentation was 20.5 years (range: 0 - 69 years), 62% were females, and 43% reported Asian ancestry. Ischemic stroke (IS) occurred in 95%, hemorrhagic stroke (HS) in 19%, and both IS and HS in 14%. Stroke recurred in 76% during follow-up; of these, 87% had IS. Because no other associated condition was found, 80% of the patients could be classified as MMD; 15% had the Moyamoya syndrome, with the presence of other conditions associated with the disease. Our hospital-based study showed a lower average age of onset than that in the literature, a much higher incidence of IS, and similar rates of HS. Patients with HS scored worse on an initial and final mRS, and surgical procedures did not significantly alter the prognosis. In comparison with those reported in international literature, we did not find significant differ- ences in disability rates between younger and older patients. The average mRS score at admission was 3.4 (range: 2 - 4), with 2.9 (range: 1 - 4) at discharge. Conclusions: Rehabilitation was able to improve the quality of life, as shown by the mRS at admission and discharge. Patients with HS tended to have worse outcomes. Keywords: Moyamoya Disease, Stroke, Neurological Rehabilitation 1. Introduction Moyamoya disease (MMD) is a chronic steno-occlusive cerebrovascular condition initially described in 1957 in a Japanese patient (1). The classic angiographic findings in- clude bilateral stenosis or occlusion at the terminal por- tion of the internal carotid artery, with an abnormal vas- cular network at the base of the brain (2, 3). Most epidemiological studies of this condition have been conducted in Asian countries, mainly Japan and Ko- rea (4). The prevalence is estimated at 6.03/100 000 (5). There have been few studies in Latin American popula- tions; one study in Brazil reported only 16 cases (6). The last epidemiological report for Brazil was a case series pub- lished in 2009 (7), and described surgical treatment in chil- dren. Only case reports so far have been conducted in a re- habilitation setting, with evaluation of prognosis or the ef- fect of a multidisciplinary approach (8). For this study, we focused on the results and experience of follow-up of pa- tients with MMD and stroke in our rehabilitation hospital. Because this is a rare disease with few descriptions in West- ern countries, the results of our work could add to the epi- demiological data and possible differences between popu- lations studied so far. 2. Objectives The aim of the present study was to evaluate a cohort of patients with MMD managed and admitted in a quater- nary, open-access rehabilitation hospital in central Brazil, and to analyze the most frequent neurological symptoms, associated conditions, duration of follow-up, and quality of life at admission and discharge. 3. Methods In this retrospective, observational study, two neurol- ogists reviewed data from electronic records of patients Copyright © 2017, Semnan University of Medical Sciences. This is an open-access article distributed under the terms of the Creative Commons Attribution-NonCommercial 4.0 International License (http://creativecommons.org/licenses/by-nc/4.0/) which permits copy and redistribute the material just in noncommercial usages, provided the original work is properly cited.