DIFFICULTIES IN DIAGNOSING MOYA-MOYA DISEASE (CLINICAL CASE)

✓ Embolism from an aneurysm is one of the mechanisms involved in the pathogenesis of ischemic symptoms associated with intracranial aneurysms. Four cases are reported in which aneurysms of the internal carotid arteries and middle cerebral arteries were the source of emboli resulting in cerebral infarction. In the treatment of these aneurysms, it is best to clip the neck of the aneurysm with great care to avoid embolism due to extrusion of clot into the distal artery.

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Unilateral sudden hearing loss as the first presenting symptom of moyamoya disease

The Journal of Laryngology & Otology ◽

10.1017/s002221511200309x ◽

2013 ◽

Vol 127 (2) ◽

pp. 196-199 ◽

Cited By ~ 1

Author(s):

L-S Tseng ◽

S-D Luo

Keyword(s):

Hearing Loss ◽

Sensorineural Hearing Loss ◽

Moyamoya Disease ◽

Carotid Arteries ◽

Internal Carotid ◽

Cerebral Arteries ◽

Sudden Onset ◽

Sudden Sensorineural Hearing Loss ◽

Sensorineural Hearing ◽

Internal Carotid Arteries

AbstractObjective:We describe a rare case of sudden onset of unilateral sensorineural hearing loss occurring as the first symptom of moyamoya disease, which is characterised by progressive stenosis of the intracranial internal carotid arteries and their proximal anterior cerebral arteries and middle cerebral arteries.Method:Case report and review of the world literature regarding moyamoya disease with hearing loss.Results:The reported patient had moyamoya disease that initially presented as sudden, unilateral sensorineural hearing loss. Magnetic resonance imaging showed occlusion of the anterior cerebral, middle cerebral and distal internal carotid arteries bilaterally. The possible mechanism of this patient's sudden sensorineural hearing loss may have been vascular occlusion resulting from thrombotic narrowing or blockage by plaque.Conclusion:The described patient represents the first reported case of sudden onset, unilateral sensorineural hearing loss occurring as the first symptom of moyamoya disease. The possibility of a vascular lesion such as moyamoya disease should be considered in patients with sudden sensorineural hearing loss, especially children, young adults and Asian patients. Due to this disease's poor outcome, early diagnosis and treatment are important to prevent stroke.

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Limits and pitfalls of indirect revascularization in moyamoya disease and syndrome

Neurosurgical Review ◽

10.1007/s10143-020-01393-1 ◽

2020 ◽

Author(s):

Pietro Fiaschi ◽

Marcello Scala ◽

Gianluca Piatelli ◽

Domenico Tortora ◽

Francesca Secci ◽

...

Keyword(s):

Internal Carotid ◽

Cerebral Arteries ◽

Surgical Approaches ◽

Cerebrovascular Disorder ◽

Surgical Revascularization ◽

Current State ◽

Middle Cerebral Arteries ◽

Indirect Revascularization ◽

Internal Carotid Arteries ◽

A Current

Abstract Moyamoya vasculopathy is a rare chronic cerebrovascular disorder characterized by the stenosis of the terminal branches of the internal carotid arteries and the proximal tracts of anterior and middle cerebral arteries. Although surgical revascularization does not significantly change the underlying pathogenic mechanisms, it plays a pivotal role in the management of affected individuals, allowing to decrease the risk of ischemic and hemorrhagic complications. Surgical approaches may be direct (extracranial-intracranial bypass), indirect, or a combination of the two. Several indirect techniques classifiable according to the tissue (muscle, periosteum, galea, dura mater, and extracranial tissues) or vessel (artery) used as a source of blood supply are currently available. In this study, we reviewed the pertinent literature and analyzed the advantages, disadvantages, and pitfalls of the most relevant indirect revascularization techniques. We discussed the technical aspects and the therapeutical implications of each procedure, providing a current state-of-the-art overview on the limits and pitfalls of indirect revascularization in the treatment of moyamoya vasculopathy.

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Time-dependent potentiation of contractile response to norepinephrine in canine isolated cerebral arteries

Canadian Journal of Physiology and Pharmacology ◽

10.1139/y91-279 ◽

1991 ◽

Vol 69 (12) ◽

pp. 1889-1895 ◽

Cited By ~ 3

Author(s):

Yasuaki Kawai ◽

Shin Yokoyama ◽

Toshio Ohhashi

Keyword(s):

Time Course ◽

Carotid Arteries ◽

Internal Carotid ◽

Contractile Response ◽

Cerebral Arteries ◽

Time Dependent ◽

External Carotid ◽

Contractile Responses ◽

Adrenoceptor Agonists ◽

Internal Carotid Arteries

The time course of contractile responses to α-adrenoceptor agonists was investigated using various arteries isolated from dogs and monkeys. The contractile response to norepinephrine was increased during the time course of the experiment in canine basilar and internal carotid arteries, whereas the response of isolated canine external carotid arteries and monkey internal carotid arteries did not change significantly. Treatment with 10−7 M propranolol, 5 × 10−6 M cocaine plus 10−5 M hydrocortisone, or 5 × 10−5 M acetylsalicylic acid did not significantly affect the time-dependent potentiation of the norepinephrine-induced contraction in canine internal carotid arteries. The time-dependent enhancement in the response to norepinephrine was also observed in the arterial preparations from which the endothelial cells were removed. The contractile response of canine internal carotid arteries to phenylephrine did not alter significantly throughout the experiments. On the other hand, the responses to clonidine and xylazine were markedly enhanced with time. Significant potentiation of the norepinephrine-induced contraction was observed in canine internal carotid arteries treated with 10−8 M prazosin, whereas 10−8 M yohimbine attenuated the time-dependent potentiation. These results suggest that the contractile responses of isolated canine basilar and internal carotid arteries to norepinephrine are potentiated during the course of the experiment, which is likely to be related, in part, to an enhancement in α2-adrenoceptor mediated contraction.Key words: α2-adrenoceptor, dog, cerebral artery, enhancement of contraction, vascular smooth muscle.

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CHEMICAL COMPOSITION OF CEREBRAL ARTERIES: THE CONCENTRATION OF LIPIDS AND MINERALS COMPARED WITH THOSE IN THE INTERNAL CAROTID

Canadian Journal of Biochemistry and Physiology ◽

10.1139/y54-059 ◽

1954 ◽

Vol 32 (1) ◽

pp. 539-547 ◽

Cited By ~ 2

Author(s):

Robert C. Buck ◽

James C. Paterson ◽

Roger J. Rossiter

Keyword(s):

Total Cholesterol ◽

Carotid Arteries ◽

Internal Carotid ◽

Cerebral Arteries ◽

Disease Process ◽

Significant Difference ◽

The Mean ◽

Severity Of The Disease ◽

Mean Concentration ◽

Internal Carotid Arteries

The concentration of total cholesterol, free cholesterol, total phospholipid, nonlipid phosphorus, calcium, and fat-free dry residue was determined in the internal carotid and cerebral arteries obtained at autopsy from a series of 14 male subjects ranging in age from 40 to 85 yr. From these figures the concentration of cholesterol ester and percentage of the total cholesterol in the ester form was calculated.In terms of wet weight, there was, in general, no significant difference between the mean concentration of lipids in the internal carotid arteries and that in the cerebral arteries. On the other hand, the mean concentration of calcium and nonlipid phosphorus was much greater in the internal carotid arteries than in the cerebral arteries.By the method of rank correlation it was found that for both vessels the concentration of total, free, and ester cholesterol was significantly correlated with both age and the severity of the atherosclerosis. Ester cholesterol expressed as a percentage of total cholesterol was also significantly correlated with age and the severity of the disease process.For the internal carotid artery, the concentration of calcium and nonlipid phosphorus was correlated with both age and the severity of the atherosclerosis. This was in contrast to the cerebral arteries in which the concentration of calcium and nonlipid phosphorus was extremely low and was found to be correlated neither with age nor the severity of the disease process.

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Reactivity of larger intracranial arteries using 7 T MRI in young adults

Journal of Cerebral Blood Flow & Metabolism ◽

10.1177/0271678x18762880 ◽

2018 ◽

Vol 39 (7) ◽

pp. 1204-1214 ◽

Cited By ~ 14

Author(s):

Baraa K Al-Khazraji ◽

Leena N Shoemaker ◽

Joseph S Gati ◽

Trevor Szekeres ◽

J Kevin Shoemaker

Keyword(s):

Cerebral Artery ◽

Carotid Arteries ◽

Internal Carotid ◽

Pulse Sequence ◽

Cerebral Arteries ◽

Cerebrovascular Reactivity ◽

Surrounding Tissue ◽

Cross Sectional ◽

The Right ◽

Internal Carotid Arteries

The larger intracranial conduit vessels contribute to the total cerebral vascular resistance, and understanding their vasoreactivity to physiological stimuli is required when attempting to understand regional brain perfusion. Reactivity of the larger cerebral conduit arteries remains understudied due to a need for improved imaging methods to simultaneously assess these vessels in a single stimulus. We characterized reactivity of basal intracranial conduit arteries (basilar, right and left posterior, middle and anterior cerebral arteries) and the right and left internal carotid arteries, to manipulations in end-tidal CO2 (PetCO2). Cross-sectional area changes (%CSA) were evaluated from high-resolution (0.5 mm isotropic) images collected at 7 T using a T1-weighted 3D SPACE pulse sequence, providing high contrast between vessel lumen and surrounding tissue. Cerebrovascular reactivity was calculated as %CSA/ΔPetCO2 in eight healthy individuals (18–23 years) during normocapnia (41 ± 4 mmHg), hypercapnia (48 ± 4 mmHg; breathing 5% CO2, balance oxygen), and hypocapnia (31 ± 8 mmHg; via hyperventilation). Reactivity to hypercapnia ranged from 0.8%/mmHg in the right internal carotid artery to 2.7%/mmHg in the left anterior cerebral artery. During hypocapnia, vasoconstriction ranged from 0.9%/mmHg in the basilar artery to 2.6%/mmHg in the right posterior cerebral artery. Heterogeneous cerebrovascular reactivity to hypercapnia and hypocapnia was characterized across basal intracranial conduit and internal carotid arteries.

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MOYA MOYA DISEASE IN A PATIENT OF THALASSEMIA MAJOR - CASE REPORT

10.36106/ijsr/0800610 ◽

2020 ◽

pp. 1-3

Author(s):

Ankita Shah

Keyword(s):

Case Report ◽

Carotid Arteries ◽

Internal Carotid ◽

Thalassemia Major ◽

Moyamoya Syndrome ◽

Inherited Disorders ◽

Moya Moya Disease ◽

Internal Carotid Arteries

The moyamoya syndrome is a cerebrovascular condition that predisposes affected patients to stroke due to progressive stenosis of the intracranial internal carotid arteries and their proximal branches. It can be seen in association with several inherited disorders. However, its association with thalassemia is very rare.

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CHEMICAL COMPOSITION OF CEREBRAL ARTERIES: THE CONCENTRATION OF LIPIDS AND MINERALS COMPARED WITH THOSE IN THE INTERNAL CAROTID

Canadian Journal of Biochemistry and Physiology ◽

10.1139/o54-059 ◽

1954 ◽

Vol 32 (5) ◽

pp. 539-547 ◽

Cited By ~ 4

Author(s):

Robert C. Buck ◽

James C. Paterson ◽

Roger J. Rossiter

Keyword(s):

Total Cholesterol ◽

Carotid Arteries ◽

Internal Carotid ◽

Cerebral Arteries ◽

Disease Process ◽

Significant Difference ◽

The Mean ◽

Severity Of The Disease ◽

Mean Concentration ◽

Internal Carotid Arteries

The concentration of total cholesterol, free cholesterol, total phospholipid, nonlipid phosphorus, calcium, and fat-free dry residue was determined in the internal carotid and cerebral arteries obtained at autopsy from a series of 14 male subjects ranging in age from 40 to 85 yr. From these figures the concentration of cholesterol ester and percentage of the total cholesterol in the ester form was calculated.In terms of wet weight, there was, in general, no significant difference between the mean concentration of lipids in the internal carotid arteries and that in the cerebral arteries. On the other hand, the mean concentration of calcium and nonlipid phosphorus was much greater in the internal carotid arteries than in the cerebral arteries.By the method of rank correlation it was found that for both vessels the concentration of total, free, and ester cholesterol was significantly correlated with both age and the severity of the atherosclerosis. Ester cholesterol expressed as a percentage of total cholesterol was also significantly correlated with age and the severity of the disease process.For the internal carotid artery, the concentration of calcium and nonlipid phosphorus was correlated with both age and the severity of the atherosclerosis. This was in contrast to the cerebral arteries in which the concentration of calcium and nonlipid phosphorus was extremely low and was found to be correlated neither with age nor the severity of the disease process.

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