• cerebral blood flow [ Time Frame: change from the baseline to12 months after treatment ]
  Cerebral blood flow refers to the flow of blood through a certain cross-sectional area of cerebrovascular in a unit time. Patients' CBF will be detected by arterial spin labeling
• perfusion status [ Time Frame: change from the baseline to 12 months after treatment ]
  perfusion status detected by Single-Photon Emission Computed Tomography

• incidence of ischemic stroke [ Time Frame: from the baseline to 12 months after treatment ]
  ischemic stroke is diagnosed by symptoms of neurologic deficit or head CT and MRI.
• incidence of transient ischemic attack [ Time Frame: from the baseline to 12 months after treatment ]
  TIA is diagnosed by patients' transient neurologic deficit
• incidence of hemorrhagic stroke [ Time Frame: from the baseline to 12 months after treatment ]
  hemorrhagic stroke is diagnosed by head CT
• The level of matrix metalloproteinase 9 (MMP-9) [ Time Frame: change from the baseline to 3, 6, 12 months after treatment ]
  Blood samples will be drawn from cubital vein to test these biomarkersThese samples will be centrifuged immediately after collection and stored at - 80 until batch evaluation
• The level of vascular endothelial growth factor [ Time Frame: change from the baseline to 3, 6, 12 months after treatment ]
  Blood samples will be drawn from cubital vein to test these biomarkersThese samples will be centrifuged immediately after collection and stored at - 80 until batch evaluation
• The level of basic fibroblast growth factor [ Time Frame: change from the baseline to 3, 6 ,12 months after treatment ]
  Blood samples will be drawn from cubital vein to test these biomarkersThese samples will be centrifuged immediately after collection and stored at - 80 until batch evaluation
• The rate of death and adverse event [ Time Frame: change from the baseline to 12 months after treatment ]
  All causes of death will be included to compute mortality at 12 months after therapy
• The number of patients with erythema,and/or skin lesions related to RIC [ Time Frame: change from the baseline to 12 months after treatment ]
  Professional doctors will check it and the investigator will record the number.
• The number of patients not tolerating RIC procedure,and refuse to continue the RIC procedure [ Time Frame: change from the baseline to 12 months after treatment ]
  the investigator will record the number.
• The rate of progression of stenosis or occlusion at Willis circle [ Time Frame: 12 months after therapy ]
  Progression of stenosis or occlusion at Willis circle was evaluated by TOF-MRA, which was defined as the the stenosis or occlusion was progressed to another part of Willis circle, like stenosis progressed from M1 to M2-M4 et al, or in the same part, stenosis progressed to occlusion.

• incidence of ischemic stroke [ Time Frame: from the baseline to 12 months after treatment ]
  ischemic stroke is diagnosed by symptoms of neurologic deficit or head CT and MRI.
• incidence of transient ischemic attack [ Time Frame: from the baseline to 12 months after treatment ]
  TIA is diagnosed by patients' transient neurologic deficit
• incidence of hemorrhagic stroke [ Time Frame: from the baseline to 12 months after treatment ]
  hemorrhagic stroke is diagnosed by head CT
• wall area [ Time Frame: change from the baseline to 6, 12 months after treatment ]
  wall area is detected by 3T high-resolution black blood vessel wall imaging
• remodeling index [ Time Frame: change from the baseline to 6, 12 months after treatment ]
  The ratio of vessel wall at maximal lumen narrowing to reference vessel. and the vessel wall is detected by 3T high-resolution black blood vessel wall
• the degree of enhancement of vessel wall [ Time Frame: change from the baseline to 6, 12 months after treatment ]
  grade 0, no enhancement; grade 1, mild enhancement, the signal intensity of vessel wall is less than that of the pituitary infundibulum ; and grade 2, strong enhancement, the signal intensity of contrast enhanced vessel wall is similar to or greater than that of the infundibulum. it was detected by 3T high-resolution black blood vessel wall
• The level of matrix metalloproteinase 9 (MMP-9) [ Time Frame: change from the baseline to 3, 6, 12 months after treatment ]
  Blood samples will be drawn from cubital vein to test these biomarkersThese samples will be centrifuged immediately after collection and stored at - 80 until batch evaluation
• The level of vascular endothelial growth factor [ Time Frame: change from the baseline to 3, 6, 12 months after treatment ]
  Blood samples will be drawn from cubital vein to test these biomarkersThese samples will be centrifuged immediately after collection and stored at - 80 until batch evaluation
• The level of basic fibroblast growth factor [ Time Frame: change from the baseline to 3, 6 ,12 months after treatment ]
  Blood samples will be drawn from cubital vein to test these biomarkersThese samples will be centrifuged immediately after collection and stored at - 80 until batch evaluation
• The rate of death and adverse event [ Time Frame: change from the baseline to 12 months after treatment ]
  All causes of death will be included to compute mortality at 12 months after therapy
• The number of patients with erythema,and/or skin lesions related to RIC [ Time Frame: change from the baseline to 12 months after treatment ]
  Professional doctors will check it and the investigator will record the number.
• The number of patients not tolerating RIC procedure,and refuse to continue the RIC procedure [ Time Frame: change from the baseline to 12 months after treatment ]
  he investigator will record the number.
• the total length of lenticulostriate arteries [ Time Frame: change from the baseline to 6, 12 months after treatment ]
  the total length of lenticulostriate arteries is detected by 3T high-resolution black blood vessel wall imaging
• average length of lenticulostriate arteries [ Time Frame: change from the baseline to 6, 12 months after treatment ]
  average length of lenticulostriate arteries is detected by 3T high-resolution black blood vessel wall imaging
• the number of lenticulostriate arteries [ Time Frame: change from the baseline to 6, 12 months after treatment ]
  the number of lenticulostriate arteries is detected by 3T high-resolution black blood vessel wall imaging

There are a series of symptoms such as ischemic stroke、transient ischemic attack 、hemorrhagic stroke、headache 、seizure and so on in moyamoya disease. Nowadays, revascularization is the only effective way for ischemic MMD while controversial for hemorrhagic MMD patients. Surgical complications including hyperperfusion syndrome, cerebral infarction or bleeding often occurred postoperatively. There is no effective conservative treatment for MMD up to now.

Remote ischemic conditioning is Remote ischemic conditioning (RIC) is a noninvasive and easy-to-use neuroprotective strategy, and it has potential effects on preventing ischemia reperfusion injury and ischemic infarction.This study was to explore the safety and efficacy of remote ischemic conditioning on adult MMD patients.

• Device: RIC
  Patients allocated to the RIC group will undergo RIC procedure during which bilateral arm cuffs are inflated to a pressure of 50 mmHg over systolic blood pressure for five cycles of 5 min followed by 5 min of relaxation of the cuffs.
• Drug: Aspirin
  patients will accept medication guided by neurologists

• Experimental: RIC group
  Patients allocated to the RIC group will undergo RIC procedure during which bilateral arm cuffs are inflated to a pressure of 50 mmHg over systolic blood pressure for five cycles of 5 min followed by 5 min of relaxation of the cuffs. They will also accept medication treatment by professional neurologists.
  Intervention: Device: RIC
• Medication group
  Patients allocated to Medication group will accept medication treatment by professional neurologists.
  Intervention: Drug: Aspirin

Inclusion Criteria:

• Age: 18-60 years
• All of the patients underwent digital subtraction angiography (DSA) and met the current diagnostic criteria recommended by the Research Committee on MMD of the Ministry of Health and Welfare of Japan in 2012.
• mRs≤3
• Informed consent obtained from patient or acceptable patient's surrogate.

Exclusion Criteria:

• Patients with acute ischemic or hemorrhagic stroke within 3 months.
• Severe hepatic or renal dysfunction.
• Severe hemostatic disorder or severe coagulation dysfunction.
• Severe cardiac diseases.
• Patients with severe existing neurological or psychiatric disease
• Patients with moyamoya syndrome caused by autoimmune disease, Down syndrome , neurofibromatosis, leptospiral infection, or previous skull-base radiation therapy.
• Patients have been done or plan to accept revascularization surgery.