Moyamoya disease as a possible cause of ischemic stroke in adult patients

Vishnyakova AYu1, Rostovtseva TM1, Kovrazhkina EA1, Golovin DA1, Gubsky IL1, Lelyuk SE2, Lelyuk VG1
About authors

1 Federal Center of Brain Research and Neurotechnologies, Moscow, Russia

2 Russian Medical Academy of Continuous Professional Education, Moscow, Russia

Correspondence should be addressed: Anastasia Yu. Vishnyakova
Ostrovityanova 1, str. 10, Moscow, 117997; ur.xednay@uahsiv

About paper

Funding: the study was part of the State Assignment 056-00171-19-01. Topic ID: АААА-А19-119042590018-0 (March 29, 2019).

Author contribution: Vishnyakova AYu — literature analysis, imaging, data analysis and interpretation, manuscript preparation; Rostovtseva TM — imaging, data analysis and interpretation, figures; Kovrazhkina EA — clinical examination; Golovin DA — imaging; Gubsky IL — data analysis and interpretation; Lelyuk SE — manuscript editing; Lelyuk VG — study concept, manuscript editing.

Compliance with ethical standards: the study was approved by the Ethics Committee of FSBI Federal Center of Brain Research and Neurotechnologies of the Federal Medical Biological Agency (Protocol dated October 4, 2021). All patients gave informed consent to participate in the study.

Received: 2021-09-29 Accepted: 2021-10-13 Published online: 2021-10-31

Moyamoya disease (MMD) is a rare progressive idiopathic arteriopathy that usually leads to ischemic stroke (IS) in young children, especially of East Asian origin. MMD can cause IS in the Caucasian race, too, but often remains unverified. The diagnosis of MMD relies on diagnostic radiology findings. Magnetic resonance imaging (MRI) is widely used in Japan to identify asymptomatic individuals with hereditary predisposition to MMD. There are no official statistics on MMD in Russia. A patient experiencing an acute cerebrovascular accident (CVA) is hospitalized to a stroke unit, where they undergo a multislice computed tomography (MSCT) scan of the brain. Below, we report the results of a complex radiological examination, which included MRI (T2, FLAIR, SWI, 3D-TOF), cerebral MSCT perfusion imaging, CT angiography of intracranial arteries, duplex ultrasonography of brachiocephalic arteries and was conducted in 4 adult Caucasian patients (3 men and 1 woman aged 38, 39, 51, and 57 years, respectively) with a past IS caused by MMD. We hope that the findings of different imaging techniques may be helpful in establishing the timely diagnosis of MMD and optimizing the treatment strategies.

Keywords: ischemic stroke, moyamoya disease, brain MRI, MR-angiography, CT-angiography, duplex ultrasonography, transcranial duplex ultrasonography