Categories

Categories group the published articles by the clinical question they help answer.

Anatomy & Classification2 articlesCauses & Genetics3 articlesCauses & Risk Factors2 articlesDiagnosis & Examination1 articlesDiagnosis & Imaging14 articlesDisease Course1 articlesLiving With Moyamoya1 articlesLiving With Multiple Sclerosis1 articlesProcedures1 articlesRecovery & Follow-up3 articlesRelapses & Recovery2 articlesStart Here3 articlesSurgery1 articlesSymptoms & Complications8 articlesSymptoms & Grading1 articlesTests & Examinations1 articlesTreatment & Management8 articlesTreatment & Surgery10 articles

Anatomy & Classification

• Goligher ClassificationFour grades describing the degree and reducibility of internal hemorrhoid prolapse.
• Internal and External HemorrhoidsHemorrhoidal tissue above and below the dentate line, with different symptom patterns and treatment considerations.

Causes & Genetics

• Causes & GeneticsWhat is known about the causes, familial patterns, RNF213, and associated conditions in moyamoya.
• Moyamoya SyndromeMoyamoya-pattern vasculopathy associated with another medical condition or exposure.
• RNF213A susceptibility gene associated with moyamoya disease in some populations.

Causes & Risk Factors

• Causes & Risk FactorsHow normal hemorrhoidal cushions become symptomatic and how bowel habit, pregnancy, aging, and other factors contribute.
• Causes & Risk FactorsWhat is known about immune biology, genetic susceptibility, and environmental associations in multiple sclerosis.

Diagnosis & Examination

• Diagnosis & ExaminationHistory, inspection, digital rectal examination, anoscopy, colon evaluation, and differential diagnosis for hemorrhoids.

Diagnosis & Imaging

• Arterial Spin Labeling MRIA noninvasive MRI perfusion method that labels arterial blood magnetically.
• Cerebrovascular ReserveThe capacity of cerebral vessels to increase blood flow when demand rises or pressure changes.
• Clinically Isolated SyndromeA first clinical episode compatible with inflammatory demyelination that may or may not meet criteria for multiple sclerosis.
• Diagnosis & ImagingHow MRI, MRA, angiography, perfusion testing, and diagnostic criteria are used in moyamoya.
• Diagnosis & MRIHow clinical context, MRI, cerebrospinal fluid, optic nerve testing, and the McDonald criteria support an MS diagnosis.
• Digital Subtraction AngiographyAn invasive catheter angiographic technique that produces high-detail images of blood vessels and blood flow.
• McDonald CriteriaSpecialist diagnostic criteria that organize clinical, imaging, cerebrospinal fluid, and optic nerve evidence for multiple sclerosis.
• MRANoninvasive magnetic resonance angiography of cerebral arteries.
• MRIMagnetic resonance imaging of brain tissue and other structural findings.
• Oligoclonal BandsCerebrospinal fluid evidence of intrathecal immunoglobulin production used in selected neurologic evaluations.
• PETPositron emission tomography for quantitative cerebral hemodynamic assessment.
• Puff-of-Smoke AppearanceThe angiographic collateral appearance that gave moyamoya disease its name.
• SPECTNuclear medicine perfusion imaging used to assess cerebral blood flow and reserve.
• Suzuki StagingAn angiographic description of how moyamoya collateral patterns evolve.

Disease Course

• Disease CoursesRelapsing-remitting, secondary progressive, and primary progressive patterns in multiple sclerosis.

Living With Moyamoya

• Living With MoyamoyaPractical topics to discuss with a care team when living with moyamoya disease.

Living With Multiple Sclerosis

• Living With Multiple SclerosisPractical planning for fatigue, heat, activity, work, cognition, mental health, preventive care, and follow-up in MS.

Procedures

• Office ProceduresRubber band ligation, sclerotherapy, infrared coagulation, selection, recurrence, pain, and complications.

Recovery & Follow-up

• Cerebral Hyperperfusion SyndromeA postoperative state in which regional blood flow rises beyond the tissue’s ability to regulate it.
• Recovery & Follow-upWhat follow-up commonly monitors before and after moyamoya revascularization surgery.
• Recovery & PreventionPain, bowel movements, activity, expected bleeding, warning signs, recurrence, and follow-up after hemorrhoid treatment.

Relapses & Recovery

• Multiple Sclerosis RelapseA new episode of inflammatory neurologic dysfunction distinguished from pseudo-relapse, progression, and emergencies.
• Relapses & RecoveryHow clinicians distinguish an MS relapse from pseudo-relapse, progression, and other urgent neurologic conditions.

Start Here

• HemorrhoidsA plain-English and clinical overview of hemorrhoids, symptoms, assessment, and treatment.
• Moyamoya DiseaseA plain-English and clinical overview of moyamoya disease, diagnosis, risks, and treatment.
• Multiple SclerosisA plain-English and clinical overview of multiple sclerosis, diagnosis, disease courses, and treatment.

Surgery

• Surgical TreatmentExcisional hemorrhoidectomy, stapled hemorrhoidopexy, hemorrhoidal artery ligation, indications, and tradeoffs.

Symptoms & Complications

• HeadacheHead pain considered by pattern, associated symptoms, and clinical context.
• Intracranial HemorrhageBleeding within the skull, including the brain tissue, ventricles, or other intracranial spaces.
• Ischemic StrokeBrain injury caused by inadequate blood flow and oxygen.
• Optic NeuritisInflammation of the optic nerve causing subacute visual loss, color desaturation, and sometimes pain with eye movement.
• Rectal BleedingBlood passed from the anus, with causes ranging from minor anorectal conditions to serious bowel disease.
• SymptomsSymptoms and emergency warning signs associated with moyamoya disease in children and adults.
• SymptomsCommon multiple sclerosis symptoms, localization patterns, and warning signs that need urgent assessment.
• Transient Ischemic AttackTemporary focal neurologic symptoms caused by inadequate blood flow without established infarction.

Symptoms & Grading

• Symptoms & GradingBleeding, prolapse, itching, discomfort, thrombosis, and Goligher grading in hemorrhoidal disease.

Tests & Examinations

• AnoscopyDirect examination of the anal canal and lowest rectum using a short illuminated instrument.

Treatment & Management

• Conservative TreatmentFiber, fluids, bowel-habit changes, short-term symptom relief, and reassessment for hemorrhoids.
• Disease-Modifying TherapyLong-term treatment intended to reduce new inflammatory activity and future injury in multiple sclerosis.
• Hemorrhoidal Artery LigationNonexcisional operation that ties arterial branches supplying internal hemorrhoids, sometimes with mucopexy.
• HemorrhoidectomySurgical excision of symptomatic internal, external, or combined hemorrhoidal tissue.
• Injection SclerotherapyOffice treatment that injects a sclerosant into selected internal hemorrhoidal tissue.
• Rubber Band LigationOffice treatment that places a small band around selected internal hemorrhoidal tissue.
• Stapled HemorrhoidopexyOperation that lifts prolapsing internal hemorrhoidal tissue using a circular stapled mucosal resection.
• TreatmentDisease-modifying therapy, relapse treatment, rehabilitation, symptom management, and monitoring for multiple sclerosis.

Treatment & Surgery

• Combined RevascularizationAn operation that combines direct bypass with one or more indirect revascularization techniques.
• Direct RevascularizationMicrosurgical bypass that immediately connects an extracranial donor artery to a cerebral recipient artery.
• EDASEncephaloduroarteriosynangiosis, an indirect revascularization procedure using a scalp artery.
• EMS and EDAMSIndirect revascularization techniques using temporalis muscle, with or without a scalp artery and dura.
• Indirect RevascularizationProcedures that place vascularized tissue near the brain so new collateral vessels can develop.
• Multiple Burr HolesAn indirect revascularization technique using several small skull openings.
• Pial SynangiosisAn indirect technique that places a scalp artery directly against the pial surface.
• STA–MCA BypassA direct bypass connecting the superficial temporal artery to a middle cerebral artery branch.
• Surgical ProceduresDirect, indirect, and combined cerebral revascularization procedures used for moyamoya.
• TreatmentAn overview of medical management, surgical decision-making, and multidisciplinary care for moyamoya.