Moyamoya disease

Case contributed by Huda B. Gharbia
Diagnosis almost certain

Presentation

Epileptic patient with recurrent attacks of ischaemic strokes proved by CT.

Patient Data

Age: 2 years
Gender: Male
mri
This study is a stack
Axial
FLAIR
This study is a stack
Axial
T2
This study is a stack
Axial
T1
This study is a stack
Axial
T1 C+
This study is a stack
Axial
DWI
This study is a stack
Axial
ADC
This study is a stack
Axial Time of
flight (Tof)
Axial
MRA
Axial
MRA
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Info

Occluded terminal right ICA supraclinoid part , occluded left ICA/MCA, with diffuse bilateral net of enhancing small vessels denoting collaterals. Meningeal hyperintensity in FLAIR sequences and T1W post contrast in both parietal and left temporal regions giving the ivy sign.

Right frontal lacunar infarction, left cerebral hemisphere atrophic changes.

Case Discussion

Moyamoya disease is a vascular occlusive disease, with the development of parenchymal, meningeal and transdural collaterals. This results in ischaemic changes, including infarction and brain atrophy.

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