Moyamoya disease and sagittal sinus thrombosis in a child with Down's syndrome.
A girl with Down's syndrome, moyamoya disease and sagittal sinus thrombosis is described. She was diagnosed after acute neurological deterioration by MRI and angiography. Recombinant tissue plasminogen activator (r-TPA) was injected locally to recanalise the thrombus. The patient's condition significantly improved and she was discharged. After 2 years of follow-up the child remains asymptomatic. Moyamoya syndrome and cerebral venous thrombosis should not be overlooked as a cause of acute neurological deterioration in a child with Down's syndrome. MRA appears to be a safe and accurate alternative to traditional angiography for the diagnosis of moyamoya disease. Local fibrinolysis with r-TPA is the treatment of choice for cerebral venous thrombosis due to its safety and efficacy.
Del-Rio Camacho
G
G
Department of Paediatrics, Fundación Jiménez Diaz, Madrid, Spain. rpediatria@fjd.es
Orozco
A L
AL
Pérez-Higueras
A
A
Camino López
M
M
Al-Assir
I
I
Ruiz-Moreno
M
M
D002675:Child, Preschool; D004314:Down Syndrome / Q000150:complications*; D005260:Female; D005343:Fibrinolytic Agents / Q000627:therapeutic use; D006801:Humans; D018810:Magnetic Resonance Angiography; D008279:Magnetic Resonance Imaging; D009072:Moyamoya Disease / Q000175:diagnosis / Q000209:etiology*; D012851:Sinus Thrombosis, Intracranial / Q000175:diagnosis* / Q000188:drug therapy / Q000209:etiology*; D010959:Tissue Plasminogen Activator / Q000627:therapeutic use
D005343:Fibrinolytic Agents; D010959:Tissue Plasminogen Activator