Disappearance of a middle cerebral artery aneurysm associated with Moyamoya syndrome after revascularization in a child: case report.
BACKGROUND
Pediatric Moyamoya disease is rarely associated with intracranial aneurysms. We report a case of a 7-year-old girl with an antecedent of persistent craniopharyngeal canal, who presented with a history of choreiform movements.


METHODS
A Moyamoya disease was found with an unruptured left middle cerebral artery aneurysm on her first angiography. Conservative treatment was chosen for the aneurysm and she underwent indirect revascularization by encephalosynangiosis using the multiple bur-hole technique for her Moyamoya disease. Abnormal movements were improved. Control angiogram at 6 months showed development of intracranial-extracranial anastomoses with complete resolution of the aneurysm. Aneuryms including the major arteries of the basal arterial circle occur as a by-product of the high velocity and blood flow secondary to the arterial stenosis. Blood flow modification after revascularization often lead to spontaneous regression and disappearance of these aneurysms.


CONCLUSIONS
Therefore, a conservative treatment of these proximal aneurysms must be chosen after encephalosynangiosis.
Peltier
Johann
J
Department of Neurosurgery, University Hospital Amiens, Amiens, France. jojo.peltier@caramail.com
Vinchon
Matthieu
M
Soto-Ares
Gustavo
G
Dhellemmes
Patrick
P
D002533:Cerebral Angiography / Q000379:methods*; D002548:Cerebral Revascularization / Q000379:methods*; D002648:Child; D005260:Female; D006801:Humans; D002532:Intracranial Aneurysm / Q000000981:diagnostic imaging / Q000209:etiology / Q000601:surgery*; D008279:Magnetic Resonance Imaging / Q000379:methods; D009072:Moyamoya Disease / Q000150:complications / Q000175:diagnosis / Q000628:therapy*; D016896:Treatment Outcome; D014656:Vascular Surgical Procedures / Q000379:methods*