Medical image of the week: moyamoya disease

• Main Authors: Pak S, Adompreh-Fia K, Valencia D, Fershko A, Short J
• Format: Article
• Language: English
• Published: Arizona Thoracic Society 2017-11-01
• Series: Southwest Journal of Pulmonary and Critical Care
• Subjects: moyamoya; angiogram; cerebral; CT scan; infarcts; MRI; thyroid; stroke; treatment; hemorrhage
• Online Access: http://www.swjpcc.com/imaging/2017/11/22/medical-image-of-the-week-moyamoya-disease.html

No abstract available. Article truncated at 150 words. A 52-year-old, right-handed, Caucasian woman with a history of hypertension and morbid obesity presented with acute onset of word-finding difficulty and slurred speech. Her medical and family history was negative for cerebral vascular event, coronary artery disease or smoking. Computed tomography of the patient's brain showed narrow caliber middle cerebral artery vasculature bilaterally. This abnormal finding prompted further investigation with cerebral angiogram. The angiogram showed bilateral high-grade stenosis of the anterior and middle cerebral arteries, worse on the left (Figure 1). Magnetic resonance imaging revealed multiple left sided punctate infarcts in the frontal and parietal lobes (Figure 2). Diagnosis of ischemic stroke secondary to moyamoya disease was established. This patient was not a candidate for fibrinolytic therapy since it had been more than 4 hours from initial presentation. She was treated with aspirin, clopidogrel, and atorvastatin for secondary prevention of ischemic stroke. Two months after her discharge date, the patient …