A Rare Manifestation of Moyamoya Disease in a 43-Year-Old Woman: A Case Report

Abstract

Introduction: Moyamoya disease (MMD) is a rare cerebrovascular disorder characterized by progressive stenosis of the major cerebral arteries and the development of a distinctive pattern of collateral vessels. Treatment approaches typically involve medical interventions to protect the brain, surgical procedures to improve blood flow, and rehabilitation therapies to address neurological deficits. Case Presentation: A 43-year-old woman presented to Imam Reza Hospital with complete sensory and motor paralysis in her left hand while performing household chores. In previous visits to hospitals, multiple sclerosis (MS) plaques were observed on MRI, leading to a diagnosis of MS. Due to the patient’s lack of response to medical therapy, cerebral angiography was performed, revealing MMD. Although the disease is most commonly diagnosed during the first decade of life, in this case, it was diagnosed in the 5th decade of life. Among the proposed treatment methods, surgical revascularization is currently considered the most effective and optimal treatment. Conclusions: This case suggests that elderly individuals with risk factors should also be screened for MMD. Moyamoya disease should always be considered, especially in MS patients who do not respond to treatment.

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