Pediatric Hemorrhagic Moyamoya Disease

Hemorrhagic MMD is an aggressive subtype characterized by posterior collateral vulnerability, female predominance, and older age. Admission mRS score ≥2 and AChA dilatation are key factors strongly associated with adverse outcomes. Conventional angiographic classification does not demonstrate a significant association with hemorrhage outcome; assessment of the posterior circulation is critical for stratifying patient outcomes and guiding early intervention.