[Intracerebral hemorrhage in a patient with moyamoya phenomenon caused by tuberculous arteritis: a case report].
A case of intracerebral hemorrhage which probably had been caused by a rupture of abnormal "moyamoya vessels" due to tuberculous arteritis was reported. A 42-year-old female had a history of tuberculous meningitis at the age of 2 years and suffered from a sudden onset of severe headache in January of 1998. CT scan disclosed a medium-sized intracerebral hematoma in the left frontal base and many calcifications in the basal cistern. Subsequent angiography demonstrated high-grade stenosis in the terminal portion of the right internal carotid artery and near-by "moyamoya vessels". No surgery was performed on the patient. A second angiography was carried out two months later and it newly disclosed ophthalmic artery-feeding "moyamoya vessels" in the place where the intracerebral hematoma had been located. This led us to conclude that a rupture of "moyamoya vessels" was the cause of the intracerebral hemorrhage and "moyamoya vessels" were not visible in the first angiograms because they had been compressed by the hematoma. Although cerebral infarction is common in tuberculous arteritis, cerebral hemorrhage is uncommon. The pathogenesis of cerebral hemorrhage due to tuberculous arteritis and its difference from that of hemorrhage caused by moyamoya disease is discussed.
Nakayama
Y
Y
Department of Neurosurgery, Fukuoka University, Chikushi Hospital, Japan.
Tanaka
A
A
Nagasaka
S
S
Ikui
H
H
D000328:Adult; D001167:Arteritis / Q000150:complications*; D002536:Cerebral Arteries / Q000000981:diagnostic imaging; D002543:Cerebral Hemorrhage / Q000209:etiology*; D005260:Female; D006801:Humans; D009072:Moyamoya Disease / Q000209:etiology*; D011859:Radiography; D014381:Tuberculosis, Cardiovascular / Q000150:complications*; D014390:Tuberculosis, Meningeal / Q000150:complications