Retinal Infarction as a Rare Complication of Cerebral Angiography in a Patient with Acute Cerebral Infarction Caused by Moyamoya Disease

Moyamoya disease is a chronic progressive cerebrovascular disease characterized by bilateral occlusion or stenosis of arteries around circle of Willis. We report a case of 18-year-old female presented with recurrent episodes of headache and vertigo. On cerebral angiography, the patient was diagnosed to have moyamoya disease. On further evaluation, thrombophilia profile showed increased homocysteine level. The patient was treated conservatively with cobalamin and aspirin and advised for revascularization. According to the literature, there are few case reports of moyamoya disease with thrombotic disorders. Hence, we are reporting this interesting and rare case.

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Long-Term Safety and Efficacy of Antiplatelet Therapy in Patients With Cerebral Infarction With Thrombocytopenia

Clinical and Applied Thrombosis/Hemostasis ◽

10.1177/1076029620980067 ◽

2021 ◽

Vol 27 ◽

pp. 107602962098006

Author(s):

Shijie Guo ◽

Yingying Lin ◽

Xiaoye Ma ◽

Yanxin Zhao ◽

Aiping Jin ◽

...

Keyword(s):

Cerebral Infarction ◽

Antiplatelet Therapy ◽

Multivariate Regression Analysis ◽

Acute Cerebral Infarction ◽

Score Change ◽

Recurrence Rates ◽

Primary Endpoints ◽

Hemorrhagic Events

This study aimed to investigate the long-term safety and benefits of antiplatelet therapy in patients with cerebral infarction with thrombocytopenia, as evidence regarding this was limited. This cohort trial assessed patients with acute cerebral infarction with thrombocytopenia treated in the Neurology Department of Shanghai Tenth People’s Hospital from January 2016 to December 2018, and enrolled patients were followed up for 9 months. The patients were divided into non-antiplatelet and antiplatelet groups based on the actual intake of antiplatelet drugs. Primary endpoints included hemorrhagic events, recurrence of cerebral infarction, and activity of daily living (ADL) score changes. To balance baseline clinical data, propensity score matching was applied, and there were finally 65 matched patients, including 30 and 35 in the antiplatelet and non-antiplatelet groups, respectively. There were no differences in hemorrhagic and cerebral infarction recurrence rates between the 2 groups. ADL score change was higher in the antiplatelet group than in the non-antiplatelet group (10 vs 5, p = 0.039). In multivariate regression analysis, antiplatelet therapy significantly predicted a positive change in ADL scores [B = 8.381, 95% confidence interval (0.56-16.19)]. In patients with acute cerebral infarction with thrombocytopenia, antiplatelet therapy could the improve the quality of life in the chronic stage.

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Intralateral and Perilateral Ventricular Arteries on Original Axial Magnetic Resonance Angiography in Adult Moyamoya Disease

European Neurology ◽

10.1159/000514429 ◽

2021 ◽

Vol 84 (2) ◽

pp. 119-123

Author(s):

Mami Ishikawa ◽

Satoshi Terao ◽

Hiroshi Kagami ◽

Makoto Inaba ◽

Heiji Naritaka

Keyword(s):

Magnetic Resonance ◽

Magnetic Resonance Angiography ◽

Cerebral Infarction ◽

Moyamoya Disease ◽

Disease Onset ◽

Time Of Flight ◽

Unruptured Aneurysms ◽

Tof Mra ◽

Adult Moyamoya Disease

Background: Patients with moyamoya disease often develop cerebral infarction and hemorrhage, but the ischemic and hemorrhagic subtypes are difficult to diagnose prior to disease onset. We aimed to differentiate the ischemic and hemorrhagic subtypes of moyamoya disease by analyzing the intralateral and perilateral ventricular arteries on the original axial magnetic resonance angiography (MRA) images. Methods: We retrospectively analyzed the intralateral and perilateral ventricular arteries on the original axial time-of-flight (TOF)-MRA images of 18 patients with hemorrhagic moyamoya disease, 25 patients with ischemic moyamoya disease, and 22 control patients with unruptured aneurysms. Results: There were significantly more intralateral and perilateral ventricular arteries on the original axial MRA images in the patients with hemorrhagic moyamoya disease (6.3 ± 2.7) than in those with ischemic moyamoya disease (0.8 ± 0.9) and those with unruptured aneurysms (0.4 ± 0.8). Conclusion: The intralateral and perilateral ventricular arteries on the original axial TOF-MRA images might suggest the hemorrhagic type of moyamoya disease prior to onset.

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