To evaluate the effect of encephalo-duro-arterio-synangiosis, (EDAS), we obtained follow-up angiograms and measured regional cerebral blood flow in 21 young patients with Moyamoya disease. Carotid fork stenosis continued to progress after EDAS, although angiography demonstrated a marked increase in the number of middle cerebral artery branches via implanted arteries. Preoperative cortical blood flow was lower than normal. The post-EDAS increases in hemispheric and cortical flow were significant in patients with transient ischemic attacks, but not in patients with infarction. The increase in cortical flow at the site of EDAS was first noted 2 weeks after EDAS.