In this study, to estimate the national epidemiological data including incidence, geographical distribution, and basic clinical features of MMD in mainland China, we used Hospital Quality Monitoring System (HQMS) maintained by the National Health Commission (NHC) from 2016 to 2018 to undertake the nationwide hospital-based observational retrospective study. Therefore, clarification of the epidemiology features of MMD in China is of great importance.

China has 34 provinces, municipalities, and autonomous regions with approximately one-fifteenth of the world's population. The annual incidence was 0♴3 per 100,000 inhabitants from 2000 to 2007 in Nanjing based on 15 major hospitals in local areas, 11 and it was 0♱5 per 100,000 inhabitants from 2000 to 2011 in Taiwan, 12 which was lower than Japan and Korea. However, the national and relatively accurate epidemiological data of MMD in China is still absent, except studies in Nanjing and Taiwan. 8, 9 In Europe, a similar upward trend has also been observed in a Danish population-based study with a relatively low annual incidence of 0♰7 per 100,000 inhabitants. In the US, although with a much lower prevalence, an increasing trend of hospital admissions was also observed. 3, 4, 5 An upward trend was also observed In Korea, and the annual incidence increased from 1♷ per 100,000 inhabitants in 2007 to 4♳ per 100,000 in 2013. 2 The national incidence of MMD in Japan and South Korea has been well-documented. MMD was more common in East Asian countries, such as Japan, Korea, and China. 1 Clinical presentations included ischemic and/or hemorrhagic stroke and cognitive impairment, which can occur in both children and adults, thus resulting in high incidence of disability and deaths.

Moyamoya disease (MMD) is a chronic cerebrovascular disease characterized by progressive narrowing of the distal internal carotid arteries and their proximal branches with abnormal collateral vessels.

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