title: Pediatric Moyamoya disease.
abstract: BACKGROUND
  Moyamoya disease (MMD) is a progressive cerebrovascular occlusive disease of the bilateral internal carotid arteries that leads to a compensatory abnormal vascular network at the base of the brain. Its average annual incidence 0.54 per 100,000 population but it is the most common pediatric cerebrovascular disease in East Asia. The reported incidence in USA is approximately 0.086 per 100,000 patients.
  
  
  METHODS
  We present a case of Moyamoya disease that was to detected in a 7-year-old female who presented with transient altered mental status.
  
  
  CONCLUSIONS
  Moyamoya disease can be diagnosed if history, physical exam and brain imaging is highly suspicious. Conventional angiography remains the gold standard for diagnosis and aids in surgical planning for patients with suspected Moyamoya disease.
authors.affiliation: Department of Pediatrics, St. John Providence Children's Hospital, Detroit, Michigan, U.S.A.
authors.forename: Mohamed
authors.initials: M
authors.lastname: Nagiub
authors.forename: Iqbal
authors.initials: I
authors.lastname: Allarakhia
keywords: Moyamoya disease; altered mental status; familial MMD; silent infarction