title: Postpneumococcal Moyamoya syndrome case report and review of the postinfective cases.
abstract: Our aim was to describe a patient who experienced a postpneumococcal Moyamoya syndrome (MMS), with a great involvement of the posterior cerebral circulation, and to review the MMS postinfective cases. A 55-year-old Pakistani man with a history of pneumococcal meningitis 3 months before developed acute headache, left otalgia and body paresthesiae. Brain CT showed a right occipital ischaemic lesion. Seven days later, he developed acute left haemianopsia, haemiplegia, haemineglect and 'frontal' cognitive and behavioural symptoms. A second brain CT and MRI disclosed an increase in the occipital lesion and the appearance of a further one in the right frontal lobe. Cerebral CT and MRI-angiography were consistent with Moyamoya vessel alterations. Treatment with antiplatelets, methylprednisolone, followed by prednisone tapering, and motor rehabilitation began. Six months later, no relapses had occurred. Our case represents a delayed manifestation of postmeningitis vasculopathy. Meningitis may represent a risk factor for developing a disabling cerebrovascular disease like MMS.
authors: Neurological Unit, S. Orsola-Malpighi University Hospital, Bologna, Italy. federicapinardi@gmail.com
authors: Federica
authors: F
authors: Pinardi
authors: Andrea
authors: A
authors: Stracciari
authors: Luca
authors: L
authors: Spinardi
authors: Maria
authors: M
authors: Guarino
mesh_terms: D002533:Cerebral Angiography; D006801:Humans; D008297:Male; D008586:Meningitis, Pneumococcal / Q000150:complications*; D008875:Middle Aged; D009072:Moyamoya Disease / Q000150:complications / Q000000981:diagnostic imaging*; D012307:Risk Factors; D013997:Time Factors
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