title: Headache attack followed by rapid disease progression in pediatric moyamoya disease--how should we manage it?
abstract: METHODS
  A 4-year-old female was presented at our hospital with frequent right frontal headache attack. She was diagnosed with moyamoya disease and was conservatively followed up. One year later, the frequency of headache gradually decreased. However, follow-up MR imaging revealed that the disease stage markedly progressed in the right side and cerebral infarction occurred in the temporal lobe with atrophy of the right frontal lobe. She underwent direct and indirect revascularization on the right side.
  
  
  CONCLUSIONS
  Aware of this case, we would like to emphasize that headache may be one subtype of ischemic attacks and require frequent MR follow-up to see the disease course. If there is any sign of disease progression, immediate surgical intervention should be indicated to avoid irreversible brain damage.
authors.affiliation: Department of Neurosurgery, Graduate School of Medicine and Pharmaceutical Science, University of Toyama, 2630 Sugitani, Toyama, 930-0194, Japan.
authors.forename: Sandra
authors.initials: S
authors.lastname: Vuignier
authors.forename: Naoki
authors.initials: N
authors.lastname: Akioka
authors.forename: Hideo
authors.initials: H
authors.lastname: Hamada
authors.forename: Daina
authors.initials: D
authors.lastname: Kashiwazaki
authors.forename: Satoshi
authors.initials: S
authors.lastname: Kuroda
mesh_terms: D002675:Child, Preschool; D017023:Coronary Angiography; D019468:Disease Management; D018450:Disease Progression; D005260:Female; D006261:Headache / Q000175:diagnosis / Q000628:therapy*; D006801:Humans; D008279:Magnetic Resonance Imaging; D009072:Moyamoya Disease / Q000150:complications* / Q000473:pathology