title: [A case of newly diagnosed moyamoya disease in a pregnant patient with a ruptured aneurysm of the distal anterior choroidal artery embolized using N-butyl cyanoacrylate].
abstract: Here we describe a rare case of a pregnant patient with a ruptured aneurysm of the distal anterior choroidal artery(AChA)that was embolized using n-butyl cyanoacrylate(NBCA). The 32-year-old patient was 24 weeks pregnant. She suddenly suffered from headache and vomiting. On admission, she was somnolent with left hemiparalysis and had a manual muscle test score of 1/5. Computed tomography(CT)images revealed a cerebral hemorrhage from the right temporal lobe to the lateral ventricle with intraventricular hemorrhage. Cerebral angiography showed severe stenosis at the terminal portion of the right internal carotid artery and a surrounding abnormal vascular network. She was diagnosed with unilateral moyamoya disease, and a direct surgical evacuation of the hemorrhage was performed on the same day. The following day, cerebral angiography showed enlargement of a distal AChA aneurysm that, as suspected, had caused the hemorrhage. The aneurysm was treated by the injection of 20% NBCA into the distal AChA and the aneurysm. After surgery, magnetic resonance imaging showed ischemic changes in the ventral posterolateral nucleus of the thalamus without neurological deficits. The patient became lucid, and the left hemiparalysis improved. The rest of the pregnancy was uneventful. At 37 weeks, she delivered a normal baby by elective caesarean section. When treating pregnant patients with moyamoya disease and a ruptured cerebral artery aneurysm, it is extremely important to cooperate with obstetricians to ensure a safe pregnancy and delivery.
authors.affiliation: Department of Neurosurgery, Fukushima Medical University.
authors.forename: Yuta
authors.initials: Y
authors.lastname: Murakami
authors.forename: Taku
authors.initials: T
authors.lastname: Sato
authors.forename: Takamitsu
authors.initials: T
authors.lastname: Tamura
authors.forename: Hyo
authors.initials: H
authors.lastname: Kyozuka
authors.forename: Shun
authors.initials: S
authors.lastname: Yasuda
authors.forename: Yasuhisa
authors.initials: Y
authors.lastname: Nomura
authors.forename: Tsuyoshi
authors.initials: T
authors.lastname: Isosu
authors.forename: Jun
authors.initials: J
authors.lastname: Sakuma
authors.forename: Keiya
authors.initials: K
authors.lastname: Fujimori
authors.forename: Kiyoshi
authors.initials: K
authors.lastname: Saito
mesh_terms: D000328:Adult; D017542:Aneurysm, Ruptured / Q000175:diagnosis / Q000209:etiology / Q000601:surgery*; D002533:Cerebral Angiography / Q000379:methods; D004621:Embolization, Therapeutic / Q000379:methods; D004659:Enbucrilate / Q000627:therapeutic use; D005260:Female; D006801:Humans; D002532:Intracranial Aneurysm / Q000150:complications / Q000175:diagnosis / Q000601:surgery*; D009072:Moyamoya Disease / Q000150:complications / Q000175:diagnosis / Q000601:surgery*; D011247:Pregnancy; D011248:Pregnancy Complications
chemical_list: D004659:Enbucrilate