title: [Three Cases of Moyamoya Disease with a History of Kawasaki Disease].
abstract: Here, we report three cases of moyamoya disease with a history of Kawasaki disease. A 33-year-old man was found to have stenotic lesions of the internal carotid arteries(ICAs)on both sides at a nearby hospital where he visited complaining of headache and lisping. He had received immunoglobulin therapy for Kawasaki disease at the ages of 1, 2, and 6 years. MRI showed only a chronic ischemic lesion in the white matter. Angiography showed occlusion at the terminal portion of the ICAs on both sides. He was diagnosed with moyamoya disease, but as he had no symptoms and preserved cerebral blood flow (CBF), he was kept under observation. An 8-year-old boy was diagnosed with moyamoya disease and underwent right encephaloduroarteriosynangiosis at a nearby hospital. He had received immunoglobulin therapy for Kawasaki disease at the age of 1 year. His ischemic symptoms worsened. Although MRI detected no apparent ischemic lesion, angiography revealed severe stenosis at the terminal portions of the ICAs on both sides, and 123I-IMP SPECT showed CBF impairment. Bilateral direct bypass was performed. His father was subsequently also diagnosed with moyamoya disease. A 4-year-old girl with epilepsy was diagnosed with moyamoya disease at a nearby hospital. She had been treated with aspirin for Kawasaki disease at the age of 1 year. MRI detected no remarkable ischemic lesions, but angiography revealed mild stenosis at the terminal portions of the ICAs on both sides. Five months later, her ischemic symptoms were worsening with progressing stenotic lesions, and she underwent bilateral direct bypass.
authors.affiliation: Department of Neurosurgery, Kyoto University School of Medicine.
authors.forename: Toshinari
authors.initials: T
authors.lastname: Kawasaki
authors.forename: Yoshiki
authors.initials: Y
authors.lastname: Arakawa
authors.forename: Toshiya
authors.initials: T
authors.lastname: Sugino
authors.forename: Takafumi
authors.initials: T
authors.lastname: Mitsuhara
authors.forename: Takeshi
authors.initials: T
authors.lastname: Funaki
authors.forename: Takayuki
authors.initials: T
authors.lastname: Kikuchi
authors.forename: Masaomi
authors.initials: M
authors.lastname: Koyanagi
authors.forename: Kazumichi
authors.initials: K
authors.lastname: Yoshida
authors.forename: Takeharu
authors.initials: T
authors.lastname: Kunieda
authors.forename: Jun C
authors.initials: JC
authors.lastname: Takahashi
authors.forename: Yasushi
authors.initials: Y
authors.lastname: Takagi
authors.forename: Susumu
authors.initials: S
authors.lastname: Miyamoto
mesh_terms: D000328:Adult; D002648:Child; D002675:Child, Preschool; D005260:Female; D006801:Humans; D008279:Magnetic Resonance Imaging; D008297:Male; D009072:Moyamoya Disease / Q000150:complications* / Q000000981:diagnostic imaging / Q000473:pathology / Q000628:therapy; D009080:Mucocutaneous Lymph Node Syndrome / Q000150:complications*; D064847:Multimodal Imaging; D011859:Radiography; D015899:Tomography, Emission-Computed, Single-Photon; D016896:Treatment Outcome