Systemic lupus erythematosus associated with Moyamoya syndrome: a case report and literature review.
Wang R,Xu Y,Lv R,Chen J
Lupus
Moyamoya syndrome (MMS) is a rare, chronic progressive cerebrovascular occlusive disease that is characterized by a stenosis or occlusion of the bilateral internal carotid arteries and the circle of Willis arteries leading to the development of collateral vessels as visualized by cerebral angiography. We report a case of a 24-year-old woman with nephrotic syndrome whose biopsy showed membranous nephropathy. Ten months after the diagnosis she suffered sudden right hemiplegia and seizure. She was diagnosed with MMS by angiogram seven months ago and received decompressive craniotomy. The patient was admitted to our hospital and a diagnosis of systemic lupus erythematosus (SLE) was made. Glucocorticoids and tacrolimus were used to control the symptoms of SLE. Following one month of immunosuppressant treatment, the patient died of brain hemorrhage. This case alongside another six reviewed cases shows that an underlying cerebrovascular lesion of moyamoya in the vessels of patients with SLE is susceptible to cerebrovascular accidents.
10.1177/0961203313485828
Moyamoya syndrome with antiphospholipid antibodies: a case report and literature review.
Wang Z,Fu Z,Wang J,Cui H,Zhang Z,Zhang B
Lupus
Moyamoya syndrome is a term applied to typical moyamoya vasculopathy with well-recognized associated conditions. Several systematic studies on the entities of moyamoya syndrome with autoimmune disease have been reported. We report a case of moyamoya syndrome with antiphospholipid antibodies and provide a review of relevant cases from the literature, describing the clinical characteristics and treatments.
10.1177/0961203314540761
Systemic sclerosis associated with moyamoya syndrome: A case report and literature review.
Chen Haifeng,Jiang Xinyu,Shi Yitian,Yuan Fenghong,Hu Zhigang
Immunobiology
Systemic sclerosis (SSc) associated with moyamoya syndrome (MMS) is a clinically rare disease. To further understand the clinical characteristics of SSc associated with MMS, we investigated and analyzed one case of SSc associated with MMS and conducted a literature review about this disease. Publications retrieved from MEDLINE and Wanfang databases were reviewed and discussed, and we found five well-described cases of SSc associated with MMS. The five patients had no family history of moyamoya disease, and the risk factors (cardiovascular disease) `were found in one of the five patients. The patients included in this study were more frequently female, and they often had limited or diffuse SSc. Unilateral involvement was frequently observed with clinical symptoms including hemiplegia, headache, loss of eyesight, and aphasia. The medical treatments included corticosteroids, immunosuppressive agents, antiplatelet agents, and anticoagulant therapy. The treatment with extra-intracranial revascularization was an effective treatment strategy for MMD and MMS. Unilateral MMD was more likely to be associated with SSc. The efficacy of corticosteroids and immunosuppressive agents was uncertain.
10.1016/j.imbio.2019.11.017
Peek through the smoke: a report of moyamoya disease in a 32-year-old female patient presenting with ischaemic stroke.
Omer Siddiq,Zbyszynska Renata,Kirthivasan Ramanathan
BMJ case reports
Moyamoya disease is a vasculopathy causing chronic progressive stenosis and occlusion of the large arteries of the circle of Willis that could lead to brain ischaemia. The condition may also present with haemorrhagic strokes. This is a case report of moyamoya disease in a 32-year-old woman presenting with ischaemic stroke. The report describes her inpatient stay and investigations and findings.The report reviews the main aspects of moyamoya disease definition, epidemiology, clinical features, diagnosis, classification and treatment. This case is interesting because her first presentation occurred after 3 months of her second delivery. Whether the different physiological stresses of pregnancy, child birth and puerperium have had some effect in accelerating the pathogenesis of her moyamoya disease remains unknown. .
10.1136/bcr-2017-221685
[A Case of Moyamoya Disease Associated with SAPHO Syndrome].
Horie Nobutaka,Baba Mayuko,Kawada Ken,Matsunaga Yuuki,Sadakata Eisaku,Morofuji Yoichi,Izumo Tsuyoshi,Morikawa Minoru,Anda Takeo,Matsuo Takayuki
No shinkei geka. Neurological surgery
Moyamoya disease is a unique occlusive disease of the internal carotid artery(ICA)with moyamoya vessels that can lead to transient ischemic attacks and hemorrhagic stroke. When other inherited or acquired disorders and conditions occur in conjunction with moyamoya disease, the syndrome is known as quasi-moyamoya disease. We report the case of a 34-year-old woman with a past history of SAPHO(Synovitis-Acne-Pustulosis-Hyperostosis-Osteomyelitis)syndrome, who presented with arm weakness and headache. Magnetic resonance angiography revealed severe terminal stenosis of the left ICA with moyamoya vessels, and she was diagnosed as moyamoya disease associated with SAPHO syndrome. She underwent superficial temporal artery-middle cerebral artery anastomosis and her arm weakness improved postoperatively. Postoperative course was uneventful, although she showed transient right paresthesia, which improved with conservative therapy. Autoimmune response could contribute to the development of this moyamoya disease, and we discuss its mechanism with a literature review.
10.11477/mf.1436203545
Postcryptococcal Moyamoya Syndrome: Case Report and Review of Literature.
Maramattom Boby Varkey
Neurology India
There could be an association between cryptococcal meningitis and the later development of moyamoya syndrome. We performed serial clinical and radiological assessments in an immunosuppressed post-renal transplant patient who had previously suffered from cryptococcal meningitis and then went on to develop a moyamoya syndrome (MMS). We also performed a literature search and review of post-infectious MMS cases from 1976 to 2019. The clinical course and radiological findings were consistent with a diagnosis of MMS. After exclusion of other causes, accelerated MMS secondary to cryptococcal meningitis, developing over 1-2 months, was considered. Our observation adds further evidence to the concept of a post-infectious MMS. This report is the first to add fungal meningitis to the etiology of an MMS.
10.4103/0028-3886.288983
A Rare Case of Postinfectious Moyamoya Syndrome: Case Report and Review of the Literature.
Trombatore Pietro,Lozupone Emilio,Gaudino Simona,Milonia Luca,Alexandre Andrea,Valente Iacopo,D'Argento Francesco,Frassanito Paolo,Pedicelli Alessandro
World neurosurgery
BACKGROUND:Postinfectious Moyamoya syndrome (MMS) is a rare vasculopathy that can follow meningitis. Only 9 cases of MMS after meningitis have been reported in the literature. We present a unique case of MMS after meningitis caused by Aspergillus fumigatus and Escherichia coli and review all cases of MMS postmeningitis in the literature. CASE DESCRIPTION:A 41-year-old man was admitted to our emergency department for sudden hypoesthesia in the left arm and an intense headache not responsive to drugs. Computed tomography scan and magnetic resonance imaging showed acute ischemic lesions in the right centrum semiovale associated with bilateral chronic watershed cerebral ischemic lesions. The cerebral digital subtraction angiography documented a typical Moyamoya pattern. In anamnesis, the patient suffered from meningitis caused by A. fumigatus and E. coli infection after neurosurgery for subependymoma of the fourth ventricle 2 years before. Laboratory tests, clinical investigation, and imaging ruled out any other cause of vasculopathy and led to the final diagnosis of postinfectious MMS. The patient started medical therapy with oral acetyl salicylic acid, verapamil, and prednisone while surgical approach was excluded in the first instance. CONCLUSIONS:Physicians should be aware of an uncommon but severe complication of meningitis such as MMS, even several years after the infection. Neuroimaging is essential for the diagnosis and to exclude other causes of neurologic symptoms in these patients.
10.1016/j.wneu.2020.05.082
Postpneumococcal Moyamoya syndrome case report and review of the postinfective cases.
Pinardi Federica,Stracciari Andrea,Spinardi Luca,Guarino Maria
BMJ case reports
Our aim was to describe a patient who experienced a postpneumococcal Moyamoya syndrome (MMS), with a great involvement of the posterior cerebral circulation, and to review the MMS postinfective cases. A 55-year-old Pakistani man with a history of pneumococcal meningitis 3 months before developed acute headache, left otalgia and body paresthesiae. Brain CT showed a right occipital ischaemic lesion. Seven days later, he developed acute left haemianopsia, haemiplegia, haemineglect and 'frontal' cognitive and behavioural symptoms. A second brain CT and MRI disclosed an increase in the occipital lesion and the appearance of a further one in the right frontal lobe. Cerebral CT and MRI-angiography were consistent with Moyamoya vessel alterations. Treatment with antiplatelets, methylprednisolone, followed by prednisone tapering, and motor rehabilitation began. Six months later, no relapses had occurred. Our case represents a delayed manifestation of postmeningitis vasculopathy. Meningitis may represent a risk factor for developing a disabling cerebrovascular disease like MMS.
10.1136/bcr-2012-006726
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