Presentation
Acute deterioration in conscious state. No known history of hypertension.
Patient Data
Large hemorrhage is noted arising in the parenchyma near the caudate head on the left side, inferiorly reaching the interhemispheric fissure and superiorly entering the ventricles. Vast amounts of intraventricular hemorrhage are present with hydrocephalus.
CTA demonstrates bilateral supraclinoid ICA occlusion with large bilateral lenticulostriate collaterals.
Case Discussion
It is important to remember that Moya-moya pattern is seen in a variety of contexts. Moya moya disease is, in contrast, idiopathic and seen primarily in children. When complications arise they can be fairly well predicted by the patient's age. Children typically suffer from ischemic events, whereas adults tend to present with hemorrhages from the lenticulostriate collateral vessels.
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