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Case Reports
. 2018 Nov 13:2018:2591494.
doi: 10.1155/2018/2591494. eCollection 2018.

Bilateral Cerebrovascular Stroke as an Initial Presenting Symptom of Moyamoya Disease

Ester Ilyayeva  1 , Khaled Nada  1 , Roxane Farahi Far  1 , Kamal Albright  1 , Manmeet Kaur Gujral  1 , Menachem Gold  1
Affiliations
Case Reports

Bilateral Cerebrovascular Stroke as an Initial Presenting Symptom of Moyamoya Disease

Ester Ilyayeva et al. Case Rep Crit Care. .

Abstract

Moyamoya disease is a rare condition affecting the circle of Willis and its branching arteries. While the pathogenesis is unclear, it causes progressive occlusion of multiple cerebral vessels leading to severe strokes. We report a case of a 47-year-old Hispanic woman with HTN presented with altered mental status and bilateral upper and lower extremity weakness with dystonic-like upper extremity movement. Serial brain CTs and angiography were performed which showed massive frontal and parietal cerebral infarcts with radiological evidence of moyamoya disease.

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Figures

Figure 1
Figure 1
Brain CT on presentation.
Figure 2
Figure 2
Axial CT images demonstrating bilateral large areas of hypoattenuation consistent with acute MCA and ACA infarcts.
Figure 3
Figure 3
Maximum intensity projection (MIP) axial image of the CT angiogram demonstrates severe stenosis of the internal carotid arteries (single arrows) and occlusion of the Rt, MCA (double arrows).
Figure 4
Figure 4
Coronal MIP demonstrates prominent lenticulostriate collaterals in the basal ganglia (arrows).
See this image and copyright information in PMC

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