[Moyamoya disease as a cause of ischemic cerebral stroke in young people].
35-year old patient was admitted to the Department of Neurology, Medical University of Bialystok because of paresis of his left upper limb, progressing over last 10 months and right facial nerve paresis, which started a month ago. During neurological examination he presented with right facial and arm paresis, dysarthric speech, obesity and hypertension. The patient was previously hospitalized in regional hospital, where a lumbar puncture was done revealing normal composition of cerebrospinal fluid. His brain CT revealed bilateral hypodensive areas in frontal and parietal regions of vasogenic character. Doppler ultrasound showed significant slowing of blood flow velocity in both internal carotid arteries. Brain angiography presented with very weak contrast filling of intracranial branches of carotid and vertebral arteries and showed stenosis at the terminal portion of the internal carotid arteries and at the proximal portion of the anterior and middle cerebral arteries. The patient had transthoracic and transesophageal echocardiography, Holter ECG, lab tests (routine lab tests plus coagulation system evaluation with C protein resistance test, anticardiolipne antibodies, antinuclear antibodies, anticytoplasmatic antibodies and thyroid hormones) checked--all tests were within normal range. Based on cerebral angiography and clinical symptoms, after excluding any other reasons of cerebral ischemia, the patient was diagnosed with moyamoya disease and arterial hypertension. The patient was treated pharmacologically with improvement--regression of face assymetry and dysarthria and diminishing of his right arm paresis. The authors of this paper pay attention to moyamoya disease as a rare reason of ischemic strokes in the young in our geographic region. They remind moyamoya disease diagnostic criteria, its etiology and treatment.
Borowik
Helena
H
Klinika Neurologii, Akademia Medyczna w Białymstoku. hborowik@wp.pl
Pogorzelski
Robert
R
Drozdowski
Wiesław
W
D000328:Adult; D000959:Antihypertensive Agents / Q000627:therapeutic use; D002545:Brain Ischemia / Q000000981:diagnostic imaging / Q000188:drug therapy / Q000209:etiology*; D002343:Carotid Artery, Internal / Q000000981:diagnostic imaging; D002533:Cerebral Angiography; D004452:Echocardiography; D017548:Echocardiography, Transesophageal; D006801:Humans; D006973:Hypertension / Q000150:complications / Q000188:drug therapy; D008297:Male; D009072:Moyamoya Disease / Q000150:complications* / Q000000981:diagnostic imaging* / Q000188:drug therapy; D018697:Nootropic Agents / Q000627:therapeutic use; D010291:Paresis / Q000188:drug therapy / Q000209:etiology; D020521:Stroke / Q000000981:diagnostic imaging / Q000188:drug therapy / Q000209:etiology*; D014057:Tomography, X-Ray Computed; D016896:Treatment Outcome
D000959:Antihypertensive Agents; D018697:Nootropic Agents