Semeiotica Biofisica Quantistica. Il Nuovo Rinascimento della Medicina.

Moyamoya disease is a progressive, occlusive disease of the cerebral vasculature with particular involvement of the circle of Willis and the arteries that feed it. The term moyamoya (Japanese for “puff of smoke”) refers to the appearance on angiography of abnormal vascular collateral networks that develop adjacent to the stenotic vessels. The steno-occlusive areas are usually bilateral, but numeorus cases show unilateral involvement.

Blood vessel walls consist of 3 layers: the intima is the innermost layer; the media is a muscular middle layer; and the adventitia is the outermost layer. Separating the intima and media is the internal elastic lamina, an elastic membrane that is considered the outermost part of the intima.

Pathologically, Moyamoya disease is characterized by intimal thickening in the walls of the terminal portions of the internal carotid vessels either bilaterally or unilaterallly. The proliferating intima may contain lipid deposits. The anterior, middle, and posterior cerebral arteries that emanate from the circle of Willis may show varying degrees of stenosis or occlusion. This is associated with fibrocellular thickening of the intima, waving of the internal elastic lamina, and thinning of the media. (

A flurry of studies suggest that a metabolomics approach may be helpful in confirming Moyamoya Disease (MMD) and providing a better understanding of MMD pathogenesis. Elevated glutamine in the CSF may be associated with MMD pathogenesis, which was different from Atherosclerotic CVD (1-4). In my opinion, this studies underline the central role played by the genetic factor, suggesting a possible Inherited Real Risk also of MMD,

Unfortunately, none study allows physician to bedside recognize MMD, even in newborn, using a stethoscope. At my best knowledge, there is no research that talks about Inherited Real Risk of MMD both in the patient and in his (her) mother.

Aiming to bedside diagnose, i.e., with a stethoscope, Moyamoya disease Inherited Real Risk, present in 100% of mothers whose children are suffering from MMD, we have to consider its real angiological features.

Notoriously, MMD is a chronic progressive steno-occlusive disease of the distal internal carotid artery or proximal anterior cerebral artery and the middle cerebral artery with abnormal moyamoya collateral vessels without associated diseases. The disease has been increasingly reported due to the technological advances of diagnostic radiology and an increase of health check-up. The studies regarding the incidence, prevalence, natural clinical course, disease progression, and surgical treatment outcomes have been increasingly reported (1-5).

Nevertheless, the precise mechanism of the disease still remains to be investigated further. In addition, heterogeneity of the ethnicity, different age at presentation, different degrees of hemodynamic compromise, surgical techniques such as direct bypass or indirect bypass surgery, and relative small sample size could lead to controversial results (5).

Quantum Biophysical Semeiotic and Clinical Microangiology help us to understand the pathophysiology and the course of the disease in the best possible way, starting from its Inherited Real Risk (6-15).

To comprehend the patho-phisiological mechanisms of QBS diagnosis of MMD, let’s consider the following experimental evidence (7).

In health, digital pressure of mean intensity (700 dyne/cm.2), applied on large artery (e.g., brachial artery) brings about simultaneously Microcirculatory Activation, type I, associated, in the distal, peripheral microcirculatory-tissue units.

Moya Moya disease bedside diagnosis is based on such a microcirculatory activation, brought about by carotid vessels and Willi’s circle heritable stenosis.

1)The oculo-gastric aspecific reflex is pathologica: unilaterally to the disorder, after a Latency Time of 4 sec. (NN = 8 sec.) appears the gastric aspecific reflex, whose intensity parallels the seriousness of underlying disorder.

2) Antognetti’s Sign, indicating CVD Inherited Real Risk or overt angiopathy, is present (16, 17).

3) Cerebro-gastric aspecific reflex during identical (700 dyne/cm.2), digital pressure on brain trigger-points of diseased area (generally, frontal-, pre-rolandic-, temporal-areas) appears after a Latency Time of 4 sec. (NN = 8 sec.).

4) Brain Evoked Cerebral Potentials show a prolonged Latency Time (18).

5) Glycocalix Evaluation results pathological in the diseased neurons (19-24).

Interestingly, the woman, positive to the Inherited Real Risk of MMD, who wants to start the pregnancy, must first perform the RMQT (25), in the personalized form, aimed at eliminating the predisposition to the disease that can affect the newborn.



  1. Jin Pyeong Jeon, MD, Taeho Yun, MS, Xing Jin, et al. H-NMR-Based Metabolomic Analysis of Cerebrospinal Fluid From Adult Bilateral Moyamoya Disease. Comparison With Unilateral Moyamoya Disease and Atherosclerotic Stenosis. Medicine (Baltimore). 2015 May; 94(17): e629. [Medline]
  2. Scott RM, Smith ER. Moyamoya disease and moyamoya syndrome. N Engl J Med 2009; 360:1226–1237. [Medline]
  3. Houkin K, Ito M, Sugiyama T, et al. Review of past research and current concepts on the etiology of moyamoya disease. Neuro Med Chir (Tokyo) 2012; 52:267–277. [Medline]
  4. Kim JE, Jeon JS. An update on the diagnosis and treatment of adult moyamoya disease taking into consideration controversial issues. Neurol Res 2014; 36:407–416. [Medline]
  5. Jin Pyeong Jeon, Jeong Eun Kim. Pathophysiology of Moyamoya Disease. Acute Ischemic Stroke pp 27-34, 2017.
  6. Sergio Stagnaro. Introduzione alla Microangiologia Clinica 10 dicembre 2011.,
  7. Sergio Stagnaro – Marina Neri Stagnaro. Microangiologia Clinica. A cura di Simone Caramel. e-book,,
  8. Stagnaro S., Stagnaro-Neri M., Il test della Apnea nella Valutazione della Microcircolazione cerebrale in Cefalalgici. Atti, Congr. Naz. Soc. Ita. Microangiologia e Microcircolazione. A cura di C. Allegra. Pg. 457, Roma 10-13 Settembre 1987. Monduzzi Ed. Bologna
  9. Stagnaro S., Valutazione percusso-ascoltatoria della microcircolazione cerebrale globale e regionale. Atti, XII Congr. Naz. Soc. It. di Microangiologia e Microcircolazione. 13-15 Ottobre, Salerno, e Acta Medit. 145, 163, 1986.
  10. Stagnaro S., Percussione Ascoltata degli Attacchi Ischemici Transitori. Ruolo dei Potenziali Cerebrali Evocati. Min. Med. 76, 1211, 1985 [Medline]
  11. Stagnaro Sergio.   Inherited Real Risk of Brain Disorders., 24 July 2009.;jsessionid=9AC82C42FA9F57C913844806BF96DDC1
  12. Sergio Stagnaro. Functional Decline in Aging , Brain Inherited Real Risk, and Co Q10 Deficiency Syndrome. 15 May, 2011.
  13. Sergio Stagnaro. Functional Decline in Aging , Brain Inherited Real Risk, and Co Q10 Deficiency Syndrome. 15 May, 2011.
  14. Sergio Stagnaro and Simone Caramel (2012) New ways in physical Diagnostics: Brain Sensor Bedside Evaluation. The Gandolfo’s Sign. January, 2012. Journal of Quantum Biophysical Semeiotics.
  15. Sergio Stagnaro and Simone Caramel (2012) New ways in physical Diagnostics: Brain Sensor Bedside Evaluation. The Gandolfo’s Sign. January, 2012. Journal of Quantum Biophysical Semeiotics.
  16. Sergio Stagnaro.  Abdominal Aortic Aneurism Inherited Real Risk: Patho-Physiology, Quantum-Biophysical-Semeiotic Symptomatology, Diagnosis and Therapy. Journal of Quantum Biophysical Semeiotics. Lectio Magistralis, SISBQ Meeting, 9,10 November, 2013, Rome.
  17. Mastroianni Davide, Stagnaro Sergio. Abdominal Aortic Aneurism: Quantum Biophysical Semeiotic Bedside Diagnosis. A Study Case.
  18. Stagnaro S., Percussione Ascoltata degli Attacchi Ischemici Transitori. Ruolo dei Potenziali Cerebrali Evocati. Min. Med. 76, 1211, 1985 [Medline]
  19. Simone Caramel and Sergio Stagnaro (2011) The role of glycocalyx  in QBS diagnosis of Di Bella’s Oncological Terrain –
  20. Simone Caramel and Sergio Stagnaro (2011). Quantum Biophysical Semeiotics of Oncological Inherited Real Risk of Myelopathy: The diagnostic role of glycocalyx.
  21. Sergio Stagnaro.  Ruolo del Glicocalice nella Valutazione Semeiotica Biofisica Quantistica della Sindrome del Fegato Iperfunzionante. 3 marzo 2011.
  22. Sergio Stagnaro. Glycocalix Quantum-Biophysical-Semeiotic Evaluation plays a Central Role in Demonstration of Water Memory-Information. 19 July, 2011.
  23. Sergio Stagnaro and Simone Caramel (2011). Skeletal Muscle Cell Glycocalix Evaluation during  CFS Treatment corroborates Andras Pellionisz’s Recursive Fractal Genome Function Principle. 
  24. Simone Caramel, Marco Marchionni  and Sergio Stagnaro. The Glycocalyx Bedside Evaluation Plays A Central  Role in Diagnosing Type 2 Diabetes Mellitus and in its Primary Prevention. Treatment Strategies – Diagnosing Diabetes, Cambridge Research Centre, Volume 6 Issue 1, Pg 41-43.
  25. Caramel S., Marchionni M., Stagnaro S. Morinda citrifolia Plays a Central Role in the Primary Prevention of Mitochondrial-dependent Degenerative Disorders. Asian Pac J Cancer Prev. 2015;16(4):1675.[MEDLINE]



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