CSF in Moyamoya Disease: Pathophysiological role and Therapeutic Perspectives

Moyamoya disease is a rare cerebral vasculopathy and progressive, characterized by occlusion of the arteries at the base of the brain and formation of fragile collateral vessels. Recent evidence indicates that cerebrospinal fluid (CSF) may act in the mediation of angiogenic, inflammatory and blood-brain barrier (BBB) dysfunction mechanisms. This systematic review aimed to analyze the biomarkers present in the cerebrospinal fluid of patients with Moyamoya and their possible diagnostic and therapeutic implications. Clinical and experimental studies were reviewed in the PubMed, Scopus and Web of Science databases, published between 2004 and 2024, using specific descriptors. You results indicate significant elevations of VEGF, FGF, IL-6 and TNF-α in the cerebrospinal fluid, indicating involvement in pathological angiogenesis and neuroinflammation processes. BBB dysfunction was also observed, suggesting increased permeability and worsening neurological damage. It is concluded that cerebrospinal fluid represents a promising source of biomarkers for early diagnosis and therapeutic guidance, contributing to more personalized approaches to disease management.