scholarly journals A 10 Years Old Child Presented with Hemiparesis and Moyamoya Disease – A Case Report

2021 ◽  
pp. 422-425
Author(s):  
Nikita H. Seth ◽  
Ashish W. Bele ◽  
Nivedita Chandrapal Singh ◽  
Mohd Irshad Qureshi ◽  
Chaitanya A. Kulkarni
Keyword(s):  
Case Report ◽  
Moyamoya Disease ◽  
Mr Angiography ◽  
Medical Center ◽  
Female Child ◽  
Favourable Outcome ◽  
Main Diagnosis ◽  
Cerebral Angiogram ◽  
Ischemic Attack ◽  
Collateral Vessels

Introduction:  In Moyamoya disease there is long standing, continuous developing occlusion of the arteries of Circle of Willis which leads to development of typical collateral vessels seen on cerebral angiogram. Moyamoya Disease was diagnosed on performing the MR Angiography. Child with Moyamoya disease presents with recurrent episodes of sudden hemiplegia that might occur at alternative sides. The disease is progressive and dynamic in children. Acute management of this disease is symptomatic. MR Angiography clinches the diagnosis and neurosurgical intervention with physiotherapy which may be required as a part of definitive management. Objectives: Our case brings forth the significance of considering Moyamoya Disease to be classic etiology for acute ischemic strokes in children. Case Report:  We report a rare case of 10 year old female child who was admitted at our medical center for the complaints of transient ischemic attack & left side hemiparesis with left facial palsy. In respect to our case, surgical intervention was not considered due to having satisfactory response on the commencing medical management. Conclusion:  Our case brings forth the importance of considering MMD to be classic etiology for acute ischemic strokes in children .MMD is main diagnosis when we evaluate the children with cerebrovascular events. To asses this non operative MR angiography is investigation of choice.  For favourable outcome in children with Moyamoya disease the key is early diagnosis and management.

scholarly journals Moya Moya Disease in a Child: A Case Report

2011 ◽  
Vol 2011 ◽  
pp. 1-2
Author(s):  
Jagdish P. Goyal ◽  
Sanjeev S. Rao ◽  
Sangita Trivedi
Keyword(s):  
Case Report ◽  
Mr Angiography ◽  
Female Child ◽  
Favourable Outcome ◽  
Cerebral Stroke ◽  
Transient Ischemic Attacks ◽  
Moya Moya Disease

We report a case of 8-year-old female child who was admitted at our hospital with complaints of transient ischemic attacks and left-sided hemiparesis. On MR angiography, the child was diagnosed to have Moya Moya disease. Moya Moya disease is a rare cause of cerebral stroke in children. The patient was treated conservatively and referred to a higher centre for specific neurosurgery. Neurosurgical revascularization process leads to favourable outcome.

scholarly journals A case report of moyamoya disease in children treated with encephalo-duro-myo-arterio-pericranial synangiosis

2021 ◽  
Author(s):  
Julius July
Keyword(s):  
Computed Tomography ◽  
Case Report ◽  
Magnetic Resonance Angiography ◽  
Moyamoya Disease ◽  
Internal Carotid ◽  
Language Function ◽  
Vascular Networks ◽  
Ischemic Event ◽  
Special Challenge ◽  
Ischemic Attack

Moyamoya disease that manifests during childhood may pose a special challenge for surgeons. We report a case of a 10-year-old girl who suffered from moyamoya disease and was successfully treated with encephalo-duro-myo-arterio-pericranial synangiosis (EDMAPS). She presented with a recurrent transient ischemic attack that worsened for 1 year. She was aphasic globally (sensory and motor) and had slightly weak right extremities. Her magnetic resonance angiography and computed tomography angiography showed the typical features of moyamoya disease with bilateral stenosis at the terminal internal carotid artery, bilaterally abnormal vascular networks, and a left ischemic event involving the temporoparietal region. She was recovered well after underwent bilateral EDMAPS, fully regained her language function after 3 months, and gathered her strength back. Therefore, EDMAPS could be a good, safe, and effective treatment for moyamoya disease in children.

scholarly journals A case of Young Stroke due to Moyamoya Disease

2020 ◽  
Vol 15 (1) ◽  
pp. 110-113
Author(s):  
Md Abdur Razzak ◽  
Ghulam Kawnayn ◽  
Fateha Naznin ◽  
Quazi Audry Arafat Rahman
Keyword(s):  
Moyamoya Disease ◽  
Past History ◽  
Cerebral Arteries ◽  
Armed Forces ◽  
Cerebral Angiogram ◽  
Medical College ◽  
Middle Cerebral Arteries ◽  
History Of ◽  
Collateral Vessels ◽  
The Right

Moyamoya disease is a disease in which certain arteries in the brain are constricted. Blood flow is blocked by the constriction, and also by blood clots (thrombosis). A collateral circulation develops around the blocked vessels to compensate for the blockage, but the collateral vessels are small, weak, and prone to bleeding, aneurysm and thrombosis which may result in TIA, recurrent ischemic or hemorrhagic stroke or seizure. The disease may manifest in pediatric age or young adults. In May 2019 we have diagnosed a young lady with Moyamoya disease who presented with right sided hemiplegia, motor aphasia and dysphagia. She was labeled as hypertensive 6 months prior to this event and used to take anti-hypertensive irregularly and gave past history of occasional headache. Her CT scan and MRI of brain revealed left sided ischemic infarct involving frontotemporoparietal region and cerebral angiogram revealed narrowing of left MCA and non-visualization of distal part. There is extensive fine collaterals (Moyamoya vessels) giving the appearance of puffed smoke. The right ACA and MCA were also narrowed with appearance of early collateral vessels. She was treated with aspirin, PPI, NG feeding, antihypertensive medication, physiotherapy, rehabilitation therapy and other supportive care. His condition gradually improved and discharged on 2.7.19. He was referred to Department of Neurosurgery for cerebral revascularization by STA-MCA (superficial temporal and middle cerebral arteries) bypass surgery after stabilization and MR perfusion study. Journal of Armed Forces Medical College Bangladesh Vol.15 (1) 2019: 110-113

scholarly journals Acceleration-selective Arterial Spin-labeling MR Angiography Used to Visualize Distal Cerebral Arteries and Collateral Vessels in Moyamoya Disease

Radiology ◽  
2018 ◽  
Vol 286 (2) ◽  
pp. 611-621 ◽  
Author(s):  
Osamu Togao ◽  
Akio Hiwatashi ◽  
Makoto Obara ◽  
Koji Yamashita ◽  
Kazufumi Kikuchi ◽  
...  
Keyword(s):  
Moyamoya Disease ◽  
Arterial Spin Labeling ◽  
Mr Angiography ◽  
Cerebral Arteries ◽  
Spin Labeling ◽  
Collateral Vessels

4D ASL-based MR angiography for visualization of distal arteries and leptomeningeal collateral vessels in moyamoya disease: a comparison of techniques

2018 ◽  
Vol 28 (11) ◽  
pp. 4871-4881 ◽  
Author(s):  
Osamu Togao ◽  
Akio Hiwatashi ◽  
Makoto Obara ◽  
Koji Yamashita ◽  
Daichi Momosaka ◽  
...  
Keyword(s):  
Moyamoya Disease ◽  
Mr Angiography ◽  
Comparison Of Techniques ◽  
Collateral Vessels

scholarly journals Periventricular anastomosis in moyamoya disease: detecting fragile collateral vessels with MR angiography

2016 ◽  
Vol 124 (6) ◽  
pp. 1766-1772 ◽  
Author(s):  
Takeshi Funaki ◽  
Jun C. Takahashi ◽  
Kazumichi Yoshida ◽  
Yasushi Takagi ◽  
Yasutaka Fushimi ◽  
...  
Keyword(s):  
Intracranial Hemorrhage ◽  
Moyamoya Disease ◽  
Mr Angiography ◽  
Multivariate Analyses ◽  
Univariate Analysis ◽  
Maximum Intensity Projection ◽  
Cross Sectional Study ◽  
Single Institution ◽  
Cross Sectional ◽  
Collateral Vessels

OBJECT The authors’ aim in this paper was to determine whether periventricular anastomosis, a novel term for the abnormal collateral vessels typical of moyamoya disease, is reliably measured with MR angiography and is associated with intracranial hemorrhage. METHODS This cross-sectional study sampled consecutive patients with moyamoya disease or moyamoya syndrome at a single institution. Periventricular anastomoses were detected using MR angiography images reformatted as sliding-thin-slab maximum-intensity-projection coronal images and were scored according to 3 subtypes: lenticulostriate, thalamic, and choroidal types. The association between periventricular anastomosis and hemorrhagic presentation at onset was evaluated using multivariate analyses. RESULTS Of 136 eligible patients, 122 were analyzed. Eighteen (14.8%) patients presented with intracranial hemorrhage with neurological symptoms at onset. Intra- and interrater agreement for rating of the periventricular anastomosis score was good (κw = 0.65 and 0.70, respectively). The prevalence of hemorrhagic presentation increased with the periventricular anastomosis score: 2.8% for Score 0, 8.8% for Score 1, 18.9% for Score 2, and 46.7% for Score 3 (p < 0.01 for trend). Univariate analysis revealed that age (p = 0.02) and periventricular anastomosis score (p < 0.01) were factors tentatively associated with hemorrhagic presentation. The score remained statistically significant after adjustment for age (OR 3.38 [95% CI 1.84–7.00]). CONCLUSIONS The results suggest that periventricular anastomosis detected with MR angiography can be scored with good intra- and interrater reliability and is associated with hemorrhagic presentation at onset in moyamoya disease. The clinical utility of periventricular anastomosis as a predictor for hemorrhage should be validated in further prospective studies.

Abstract 2786: Moyamoya Syndrome Associated With Graves' Disease: Report Of 16 Cases

Stroke ◽  
2012 ◽  
Vol 43 (suppl_1) ◽  
Author(s):  
Jun NI ◽  
Li-xin ZHOU ◽  
Yan-ping WEI ◽  
Lian DUAN ◽  
Shan GAO ◽  
...  
Keyword(s):  
Moyamoya Disease ◽  
Cerebral Arteries ◽  
Laboratory Data ◽  
Thyroid Stimulating Hormone ◽  
Graves Disease ◽  
Thyroid Function Tests ◽  
Moyamoya Syndrome ◽  
College Hospital ◽  
Ischemic Attack ◽  
Collateral Vessels

Background and purpose Moyamoya disease is a cerebrovascular disorder characterized by bilateral progressive stenosis and occlusion of terminal portions of internal carotid artery (ICA) accompanying by typical net-like collateral vessels. Patients with both the characteristic moyamoya vasculopathy and the associated conditions are categorized as moyamoya syndrome. These conditions include sickle cell disease, neurofibromatosis type 1, Down’s disease, cranial therapeutic irradiation and other rare diseases. Moyamoya syndrome associated with Graves’ disease has been rarely reported and the underlying coexisting mechanism remains unclear. The aim of this study is to identify the clinical and radiological findings of the patients with simultaneous diagnosis of moyamoya syndrome and Graves’ disease. Possible mechanisms predisposing these individuals to ischemic accidents are discussed. Methods We retrospectively identified 12 patients in Peking Union Medical College Hospital and 4 patients in 307 hospital of PLA between May 2000 and December 2010. All patients were female and mean age (range) was 35.13±12.34 years (11-57 years). The patients were diagnosed with Graves’ disease in endocrinology clinic which meet the full diagnostic criteria and no atherosclerotic factor was found in them. Moyamoya vasculopathy was definitely or probably diagnosed by digital subtract angiography or magnetic resonance angiography. The clinical characteristics and prognosis, laboratory data, vascular radiological characteristics were all collected. Results Stenosis or occlusion of bilateral distal ICA and/or proximal anterior /middle cerebral arteries was found in 13 patients. Three patients had unilateral distal ICA stenosis and abnormal collateral vessels. PCA stenosis was found in 2 patients. Fifteen patients presented with infarction or transient ischemic attack and one with dizziness. Interestingly, thyroid function tests demonstrated predominantly elevated thyroxine and suppressed thyroid stimulating hormone level in 15 patients when cerebrovascular accidents occurred. All patients received antithyroid therapy and two had recurrent ischemic attack after several months of drug withdrawal. Four patients underwent revascularization procedures after normalization of their hormonal conditions in 307 Hospital of PLA and their neurologic status has remained stable during follow-up. Conclusions: Compared with classical moyamoya disease, moyamoya syndrome associated Graves’ disease more commonly presented asymmetric stenosis or occlusion and PCA lesions. Cerebrovascular hemodynamic changes attributable to thyrotoxicosis might be responsible for ischemic attack and further studies are required to verify this hypothesis.

Assessment of extracranial-intracranial bypass in Moyamoya disease using 3T time-of-flight MR angiography: Comparison with CT angiography

VASA ◽  
2014 ◽  
Vol 43 (4) ◽  
pp. 278-283 ◽  
Author(s):  
Qian Chen ◽  
Rongfeng Qi ◽  
Xiaoqing Cheng ◽  
Changsheng Zhou ◽  
Song Luo ◽  
...  
Keyword(s):  
Image Quality ◽  
Moyamoya Disease ◽  
Mr Angiography ◽  
Time Of Flight ◽  
Consecutive Series ◽  
Tof Mra ◽  
Bypass Patency ◽  
Significant Difference ◽  
Contrast Technique ◽  
Vessel Integrity

Background: To evaluate the value of time-of-flight MR angiography (TOF MRA) for the assessment of extracranial-intracranial (EC-IC) bypass in Moyamoya disease in comparison with computed tomography angiography (CTA). Patients and methods: A consecutive series of 23 patients with Moyamoya disease were analyzed retrospectively. Twenty three patients underwent 25 procedures of extracranial-intracranial bypass. Cranial CTA was performed within one week after the surgery to assess bypass patency. Then TOF MRA was scanned within 24 h after CTA on a 3T MRI system. Using 5-point scales (0 = poor to 4 = excellent), two radiologists rated the image quality and vessel integrity of bypass for three segments (extracranial, trepanation, intracranial). Results: Image quality was high in both CTA and TOF MRA (mean quality score 3.84 ± 0.37 and 3.8 ± 0.41), without statistical difference (p = 0.66). Mean scores of TOF MRA with respect to bypass visualization were higher than CTA in the intracranial segment (p = 0.026). No significant difference of bypass visualization regarding the extracranial and trepanation segments was found between TOF MRA and CTA (p = 0.66 and p = 0.34, respectively). For the trepanation segment, TOF MRA showed pseudo lesions in 2 of all 25 cases. Conclusions: 3T TOF MRA, a non-contrast technique not exposing the patients to radiation, proved to be at least equal to CTA for the assessment of EC-IC bypass, and even superior to CTA with respect to the intracranial segment. In addition, readers should be aware of a potential overestimation showing focal pseudo lesions of the bypass at the trepanation segment in TOF MRA.

Coarctation of the abdominal aorta: Demonstration of a rare anomaly using contrast-enhanced MR-angiography

VASA ◽  
2009 ◽  
Vol 38 (1) ◽  
pp. 66-71 ◽  
Author(s):  
Schubert
Keyword(s):  
Abdominal Aorta ◽  
Mr Angiography ◽  
Parallel Imaging ◽  
Left Renal Vein ◽  
Systemic Hypertension ◽  
Contrast Enhanced ◽  
Younger Age ◽  
Maximum Intensity Projections ◽  
Collateral Vessels ◽  
First Time

We describe a case of aortic coarctation at the level of the infrarenal abdominal aorta which is encountered in less than six individuals in one million. In contrast to aortic narrowing above or including the renal arteries, this seems to be a relatively benign anomaly without systemic hypertension or impaired renal function. For the first time in this type of anomaly, contrast-enhanced MR angiography (ce-MRA) on a multi-receiver channel MR system, with an 8-channel phased array coil and parallel imaging was used. Ce-MRA displayed a tortuous, narrowed aortic segment that was found to be associated with mesenteric artery stenosis and compression of the orthotopic left renal vein, also known as the nutcracker phenomenon. All major aortic branches could be depicted using 3D surface-shaded displays and subvolume maximum intensity projections (MIPs). Collateral vessels of the abdominal wall were identified using whole-volume MIPs. Since the majority of aortic malformations are diagnosed at a younger age, and many suffer from renal insufficiency, we conclude that ce-MRA will eventually place conventional DSA as the modality of choice in malformations of the abdominal aorta.

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