Moyamoya disease in an extremely old patient.
OBJECTIVE
The oldest patients diagnosed with moyamoya disease (MMD) in the USA may have been as old as 85+ years, and 68 years in Taiwan; therefore, MMD is generally thought not to occur in extremely old patients in Taiwan. Herein, we report this case to revise the common thinking.


METHODS
An 82-year-old woman had suffered twice from a right cerebral infarction. A digital subtraction angiogram demonstrated abundant collateral arterial networks from the bilateral proximal middle cerebral arteries despite the absence of arteriosclerotic stenosis of the bilateral extracranial internal carotid arteries. Aspirin has effectively controlled her symptom since diagnosis and, as a result, a direct or indirect revascularization procedure is unnecessary.


CONCLUSIONS
MMD does occur in extremely old Taiwanese, as old as over 80 years old, and thus should be a differential diagnosis of cerebral infarction in an extremely old patient. Digital subtraction angiography is the gold standard for the diagnosis.
Department of Medical Imaging, Taipei Medical University and Shuang Ho Hospital, New Taipei, Taiwan.
Jiann-Jy
JJ
Chen
Department of Medical Imaging, Taipei Medical University and Shuang Ho Hospital, New Taipei, Taiwan.
Kuo-Luon
KL
Kung
Department of Medical Imaging, Taipei Medical University and Shuang Ho Hospital, New Taipei, Taiwan.
Chi-Jen
CJ
Chen
Department of Medical Imaging, Taipei Medical University and Shuang Ho Hospital, New Taipei, Taiwan.
Ying-Chi
YC
Tseng
G-Home Clinic, Kaohsiung, Taiwan.
Dem-Lion
DL
Chen
Yao Mao Clinic, Changhua, Taiwan.
Yao-Mao
YM
Tang
D000367:Age Factors; D000369:Aged, 80 and over; D015901:Angiography, Digital Subtraction; D002533:Cerebral Angiography; D002544:Cerebral Infarction / Q000209:etiology / Q000473:pathology; D038524:Diffusion Magnetic Resonance Imaging; D005260:Female; D006801:Humans; D009072:Moyamoya Disease / Q000150:complications / Q000000981:diagnostic imaging* / Q000473:pathology*