Surgery Related Questions for Moyamoya

There is some incisional scalp pain and tenderness for about a week after surgery. In addition, some patients have headaches. Medication is provided to minimize the discomfort.

Patients are advised to stay on lifelong aspirin after bypass surgery for moyamoya. This is used to help keep optimal blood flow through the bypass. Patients who have side effects from the aspirin such as excessive bruising/bleeding or stomach upset should contact Dr. Steinberg's office. Other possible medications will be reviewed with patients on an individual basis during hospitalization or at each clinic visit.

Most patients are in the hospital for 2-4 days after each bypass surgery. The first night is in the ICU and the other nights are usually on the neurosurgery ward. However, each patient recovers at a different rate and may have different hospitalization needs.

We want you to be up and around starting the second day after surgery. Activity will be limited to walking, with distance and time increasing gradually over a month. After one month, most pre-operative activities can be resumed. Specific activity restrictions will be reviewed during your postoperative clinic visit.

Hydration is important to help keep your blood volume up and therefore keep adequate flow through the bypass grafts. IV hydration is maintained while you are in the hospital. After discharge, patients are advised to drink about 2 liters of fluids each day.

The scalp can be wet if the incision is covered with waterproof tape starting a few days after surgery. Hair can be washed without covering the incision starting one week after surgery.

Most adult patients have incisions closed with staples. It takes at least 7 full days for the incision to heal enough for staples to be removed. The incisions of pediatric patients are often closed with dissolvable suture material, which dissolves over a period of a couple of weeks.

Patients should wait until the incision is well healed before coloring or using processing agents on their hair. This generally takes at least 4 weeks, and sometimes a few weeks longer.