So, once a year I come back here and update my situation.

My moyamoya was found completely by accident.  I was and am completely asymptomatic.  I had an MRI due to severe vertigo during allergy season in 2011 and discovered the moyamoya. 

Stanford was recommending surgery immediately.  I was lucky enough to get a consult with Dr Michael Scott at Children's Hospital Boston even though I was 40.  He recommended a wait and see approach and put me in touch with Dr Rose Du who is my neurosurgeon (whom I love).

We have been monitoring my occlusion every 6 months by CT.  After 3 stable (no change) tests, we switched to MRI and it appeared there was progression.  We double checked by CT and discovered it was just the difference in the technologies.

So, 3 years, no change.  The dr now thinks that I have had this for a long time and that my body has just adapated around it.  As long as I'm asymptomatic, we are continuing to monitor yearly now but will not take any action.

Coincidentally, I met a new work colleague recently whose husband has the same situation - condition found by accident, no symptoms, wait and see approach.

So, that's the update.  Hope all here are finding the answers they need.

Jill