Moyamoya disease

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Suzuki staging system for Moyamoya

Stage Finding
1 Stenosis of suprasellar ICA, usually bilateral
2 Development of moyamoya vessels at base of brain. ACA, MCA, & PCA dilated
3 Increasing ICA stenosis & prominence of moyamoya vessels (most cases diagnosed at this stage). Maximal basal moyamoya
4 Entire circle of Willis and PCAs occluded, extracranial collaterals start to appear, moyamoya vessels begin to diminish
5 Further progression of stage 4 with intensification of ECA collaterals & reduction of moyamoya associated vessels
6 Total occlusion of ICA & major cerebral arteries and complete absence of moyamoya vessels