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Research ArticleLetter

Moyamoya Syndrome in Cocaine-dependent Patients

R. Michael Scott
American Journal of Neuroradiology November 2000, 21 (10) 1977-1980;
R. Michael Scott
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I enjoyed Storen et al's article regarding two cocaine-dependent patients who manifested angiographic changes that suggested moyamoya syndrome (1). We published a similar case in the on-line journal, Neurosurgical Focus, the internet journal of the Journal of Neurosurgery (2). Our patient was a 30-year-old, right-handed, Caucasian woman who had heavy dependency on intranasal cocaine from the ages of 16–27. She presented with a long history of headache, which was worsening in frequency and intensity, and with dysphasia and right-sided weakness. CT and MR studies showed multiple, small cerebral infarctions of different ages, and cerebral anteriography revealed evidence of advanced-stage moyamoya changes, with virtual occlusion of supraclinoid carotid arteries bilaterally. Despite aspirin treatment, the patient continued to have symptoms, and she underwent eventual bilateral pial synangioses to enhance collateralization to each hemisphere. The postoperative arteriograms indicated excellent collateralization bilaterally, and the patient has remained neurologically stable without further events for the past 9 years. Pre- and postoperative arteriograms are available on the on-line publication (www.neurosurgery.org/focus/november98/5-5-7.html). We also thought that the network of collateral vessels beyond the bilateral carotid occlusive process implied an insidious progressive process rather than an acute event, and felt that chronic vasoconstriction was the most likely explanation for the development of the angiographic and clinical phenomena.

References

  1. ↵
    Storen EC, Wijdicks EFM, Crumb A, Schultz G. Moyamoya-like vasculopathy from cocaine dependency. AJNR Am J Neuroradiol 2000;21:1008-1010
    Abstract/FREE Full Text
  2. ↵
    Schwartz MD, Scott RM. Moyamoya syndrome associated with cocaine abuse. Neurosurg Focus 1998;5: Article 7
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American Journal of Neuroradiology
Vol. 21, Issue 10
1 Nov 2000
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Moyamoya Syndrome in Cocaine-dependent Patients
R. Michael Scott
American Journal of Neuroradiology Nov 2000, 21 (10) 1977-1980;

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Moyamoya Syndrome in Cocaine-dependent Patients
R. Michael Scott
American Journal of Neuroradiology Nov 2000, 21 (10) 1977-1980;
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