VascularSpontaneous middle cerebral artery occlusion leading to moyamoya phenomenon and aneurysm formation on collateral arteries
Section snippets
Case report
A 63-year-old woman presented with a sudden onset of aphasia and right hemiparesis. Her blood pressure recordings revealed that she was normotensive (140/70 mmHg). Her computed tomography (CT) scan showed approximately 40 mL of left putaminal hematoma and a small amount of subarachnoid clot in the left Sylvian fissure (Figure 1). There was no intraventricular hemorrhage. Her left carotid angiogram demonstrated a severe focal stenosis in the proximal segment (M1) of the MCA. The circulation to
Discussion
In 1981 Fukawa et al described a clinical entity of spontaneous MCA occlusion associated with moyamoya phenomenon [1]. Patients with this disease usually present with either cerebral hemorrhage or ischemia in their 5th or 6th decade, but this disease can also be found in childhood [12]. This category of cerebrovascular occlusive disease is distinct from moyamoya disease as the carotid angiogram shows occlusion or stenosis restricted to the M1 segment of the MCA associated with localized
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Cited by (31)
Characterization of Moyamoya and Middle Cerebral Artery Diseases by Carotid Canal Diameter and RNF213 p.R4810K Genotype
2022, Journal of Stroke and Cerebrovascular DiseasesMoyamoya Vasculopathy: Cause, Clinical Manifestations, Neuroradiologic Features, and Surgical Management
2022, World NeurosurgeryCitation Excerpt :The development of moyamoya collaterals may serve as an endogenous bypass procedure and have a protective role from hypoperfusion. Data from the literature have shown that intracranial hemorrhage can be related to the direct rupture of these tiny vessels or to aneurysm bleeding formed on their wall as described in patients with MMD.72,73 Tanaka et al.74 showed that in MMS, secondary to intracranial atherosclerosis, moyamoya vessels are more developed in the presence of multiple steno-occlusive lesions involving the ACA and MCA and in poorly developed leptomeningeal collateral vessels from the ACA.
Microsurgical Repair of Ruptured Aneurysms Associated with Moyamoya-Pattern Collateral Vessels of the Middle Cerebral Artery: A Report of Two Cases
2017, World NeurosurgeryCitation Excerpt :Surgery has the added benefit of allowing evacuation of a cerebral hematoma or decompressive craniectomy, as was done in our cases. Although the limited number of reported cases makes it difficult to definitely recommend a treatment strategy, microsurgical approach appears to be safe and effective and should be considered, given the high mortality associated with aneurysm rebleed if left untreated.4,9-11,31,46-48 Alternative interventions to microsurgery also should be considered, depending on the location and accessibility of the aneurysm.
Ruptured Basilar Tip Aneurysm in a Patient with Bilateral Internal Carotid Artery Occlusion Successfully Treated with Bilateral Superficial Temporal Artery-Middle Cerebral Artery Anastomoses: Case Report
2016, World NeurosurgeryCitation Excerpt :Hemodynamic stress can lead to the formation of cerebral aneurysms.1-5 Stenosis or occlusion of intracranial or extracranial arteries can result in the development of a collateral blood network, which may increase the hemodynamic stress and subsequent aneurysm formation.5,6 We report a case of a ruptured basilar tip aneurysm in an adult with bilateral internal carotid artery (ICA) occlusion.