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Query: UMLS:C0018681 (headache)
 56,091 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

A case of subacute subdural hematoma associated with moyamoya phenomenon is reported. On May 8, 1986, a 61-year-old female was referred to Mito National Hospital for evaluation of a left-sided hemiparesis and headache 8 days after minor head injury. Seventeen years ago she experienced the sudden onset of a left-sided hemiparesis which improved by rehabilitation. CT scans showed a thin high density area on the right cerebral convexity and a small low density area in the right semiovale center. On May 12, she was admitted because of aggravation of her symptoms. A repeat CT scan showed an enlarged right temporoparietal subdural hematoma with significant mass effect. Cerebral angiograms revealed the occlusion of right internal carotid artery. There were so-called moyamoya vessels bilaterally and transdural anastomosis on the right side. Avascular area confirmed subdural hematoma. The hematoma was evacuated via two burr holes with preservation of the middle meningeal and superficial temporal arteries. By the time of discharge two months postoperatively, she was walking well without assistance. We reviewed four cases of acute or subacute subdural hematoma associated with moyamoya phenomenon and emphasized the possibility of occurrence of acute or subacute subdural hematoma due to rupture of vault moyamoya vessels.
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PMID:[Subacute subdural hematoma associated with moyamoya phenomenon--a case report]. 328 35

In order to show the vascular anatomy in periventricular region, two adult cases of moyamoya disease with intracerebral hemorrhage extending into lateral ventricle were presented. And we discussed the relation between the vascular anatomy and the form of hemorrhage in moyamoya disease. The first case was a 46-year-old woman admitted for nausea and vomiting following headache for four days. CT scan revealed a high density area in the upper portion of body of right lateral ventricle showing intracerebral hemorrhage which extended into the lateral ventricle. On angiogram, typical moyamoya disease was noted. The ventriculofugal arteries from the posterior lateral choroidal artery was detected which indicated developed ventriculofugal perfusion. The second case was a 52-year-old man who was hospitalized sudden onset of headache, vomiting and consciousness disturbance. CT scan revealed a high density area suggesting of hemorrhage in the head of right caudate nucleus. It perforated into the right anterior horn of lateral ventricle with spreading over the other ventricles. We observed similar findings on the angiograms to the first case. In this case, however, the lateral striate arteries were involved instead of the posterior lateral choroidal artery. It should be pointed out that, in both cases, the area of hemorrhage in CT scan coincided with the area of developed ventriculofugal perfusion in angiograms.
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PMID:[Two adult cases of moyamoya disease with intraventricular hemorrhage--angiographic evaluation of periventricular vascular anatomy]. 377 99

Intracranial hemorrhage during pregnancy is rare. The authors present a case of moyamoya disease associated with pregnancy. A 32-year-old woman who was at 32 weeks of gestation experienced sudden severe headache followed by loss of consciousness. Computed tomography revealed an intracerebral hematoma in the left temporal lobe, and left carotid angiograms revealed moyamoya disease. The patient underwent emergency craniotomy, the hematoma was removed, and encephaloduroarteriosynangiosis was performed. The patient showed good recovery and, 2 months later, delivered a child vaginally without any trouble. Most intracranial hemorrhages during pregnancy result from cerebral aneurysms or arteriovenous malformations (AVMs), and few cases due to moyamoya disease have been reported. It is generally believed that subarachnoid hemorrhage due to cerebral aneurysms is likely to occur during the middle trimester of gestation, with the risk increasing progressively toward the third trimester. This may be explained by the fact that the cardiac output increases rather acutely from the first to the middle trimester. There seems to be no significant correlation between the stage of pregnancy and the occurrence of hemorrhage due to AVM. Most authors think that the operative indications for intracranial hemorrhage during pregnancy should be the same as for the nonpregnant state.
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PMID:Moyamoya disease presenting as intracerebral hemorrhage during pregnancy: case report and review of the literature. 380 70

The prognosis of 27 patients with moyamoya disease was studied. The ages at onset ranged from 11 months to 4-11/12 years. Follow-up study was performed within 4 years from the onset in 13, 5 to 9 years in 5, and 10 to 15 years in 9. Transient ischemic attacks (TIA) occurred most often during the first four years and decreased thereafter. Intellectual deterioration and neurologic deficits increased with time. Outcome included no sequelae in five (19%), occasional TIA or headache alone in nine (33%), mild intellectual and/or motor impairment in seven (26%), requirement for special school or care by parents or institutions after reaching the teen years in three (11%), continuous 24-hour care in two (7%), and death in one (3%). Poor prognosis was correlated with an early age at onset and hypertension.
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PMID:Prognosis of occlusive disease of the circle of Willis (moyamoya disease) in children. 388 Apr 14

Seventeen patients with basal occlusive disease have been seen over the past 4 years. Nine of these had a classical moyamoya appearance on angiography. Of these nine, seven were adults and two were children. Eight had ischemic episodes, and one had a hemorrhage. One had neurofibromatosis with a chiasmal glioma and had received radiotherapy. Eight patients underwent superficial temporal-middle cerebral artery (STA-MCA) bypass, and one refused operation. Six patients improved, one had a stroke on the opposite side, and one died. Eight patients had unilateral basal arterial occlusive disease. Of these, three had ischemic episodes, four had hemorrhages, and one had only headaches. Four were adults, and four were children. Five underwent STA-MCA bypass with improvement, one with headaches had an aneurysm treated, and two were not operated upon. Considerations regarding the cause, therapeutic options, and disease course in these patients are discussed.
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PMID:Basal arterial occlusive disease. 408 Jan 27

Clinical features of ten Japanese children with cerebrovascular Moyamoya disease are reported and non-Japanese paediatric cases of the disease are reviewed from the world literature. The most common initial manifestations were headache in four cases (40%), motor deficit and convulsion in three cases (30%). As their recurrent and/or residual symptoms, eight children (80%) developed motor deficit consisting of hemiplegia in five cases and paresis or weakness of the extremities in three cases, and four (40%) had headaches. The mode of presentation in our cases was similar to that of non-Japanese cases, in addition to a female preponderance. Electroencephalographic findings of prominent high voltage delta bursts following hyperventilation and slowness of returning to the normal pattern, seen in all hyperventilated cases, is one of the features. Of 15 carotid arteries visualised in ten patients, sites of occlusion or stenosis were seen between the bifurcation of the posterior communicating artery and that of the anterior cerebral artery or the middle cerebral artery in 13 arteries, with a vascular network in the basal ganglia. This study suggests that if hyperventilation procedures produce prominent high voltage delta bursts during electroencephalography in children with headache and/or motor deficit, cerebrovascular disease, especially Moyamoya disease, should be suspected.
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PMID:Cerebrovascular Moyamoya disease. 637 Jun 99

Moyamoya disease was originally defined as a characteristic syndrome of recurrent headaches, occlusion of the distal internal carotid arteries and the foggy (moyamoya) clusters of collateral vessels at the base of the brain as demonstrated by cerebral angiography. The etiology is unknown and pathobiology is poorly understood. We examined the intracranial arteries in 3 patients to demonstrate characteristic changes and to obtain a better understanding of the basis mechanisms of the disease. Controls were obtained from 3 normotensive patients who died as a result of cancer. Occluded internal carotid arteries were characterized by severe thickening of the intima with a dense luminal array of smooth muscle cells, a deeper less cellular zone, pronounced tortuosity of the internal elastica and thinning of the media. Collateral vessels were arterial in structure and were affected by similar proliferative changes in the intima, thinning of the media, and contorted internal elastica. Stainable lipids were not part of the typical components. Severe contortion of the internal elastica, medial damage and intimal proliferation may result from recurrent and sustained spasticity of the cerebral arteries. The distal lenticulostriate arteries showed severe medial damage similar to what is termed as a moth-eaten change in hypertensive patients dying of massive cerebral hemorrhage.
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PMID:Ultrastructural studies of cerebral arteries and collateral vessels in moyamoya disease. 646 67

A case of coexisting moyamoya disease and craniopharyngioma in an 8-year-old boy is reported. The patient had been suffering from recurrence of transient right hemiparesis with headache and vomiting during the three years before admission. After the diagnosis of both moyamoya disease and craniopharyngioma, evacuation of the cystic fluid of the craniopharyngioma, encephalomyosynangiosis , and internal irradiation through an Ommaya drainage system were carried out. The symptoms gradually improved after these procedures. The relation of moyamoya disease to craniopharyngioma is discussed. We consider that internal irradiation is one of the best means of treatment for a cystic craniopharyngioma associated with moyamoya disease.
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PMID:Moyamoya disease associated with craniopharyngioma. 671 33

A 53-year-old, non-hypertensive farmer, who had sudden attack of severe headache, was transferred to our clinic. He presented comatous state and tetraparesis without extraocular movements nor reactive pupils to light. CT scan, 7 hours after the ictus showed intracerebral hematoma in the right temporo-parietal region with ventricular extension. The following bilateral carotid angiograms established the diagnosis of the intracerebral hemorrhage due to cerebrovascular moyamoya disease. In angiograms of the affected side, irregular spotty stains spread from the periphei of the right posterior choroidal artery was delineated. The repeated CT scan after that indicated increment of hematoma. Fifty-three hours from the ictus, the patient died and an autopsy study was performed. After the fixation, the coronal brain section was made, and the careful observation of them elucidated the formation of an organized dissecting aneurysm in the angiographically extravasated vessel. About seven hundreds of serial specimen, 4 micron in thickness, was then investigated adjacent to the aneurysm. The organized dissecting aneurysm seemed to initiate from the branch of it, where marked fraying and undulation of the fibroelastic intima and internal elastic laminae were observed. The concavity toward the true lumen was completely disrupted and communicated to the extravascular space. As a result, the continuous part of it obstructed the lumen of the branch. These findings suggested the newly-developed dissection and it seemed to correspond to the angiographical extravasated points.
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PMID:[Angiographical extravasation in the intracranial hemorrhage due to cerebrovascular moyamoya disease--autopsy study]. 674 3

Two cases of Moyamoya disease associated with persistent primitive trigeminal artery (PTA) are reported. Case 1: A 44 year-old man had sudden severe headache and found to have a subcortical hematoma in the left temporo-parietal lobe by CT-scans. Four vessel study revealed the right PTA and Moyamoya disease. Case 2: A 56 year-old woman suffered sudden severe headache and was diagnosed as subcortical hematoma in the right temporo-parietal lobe by CT scans. The left PTA and Moyamoya disease were revealed by four vessel study. In the previously reported 232 cases with PTA, we couldn't find out any case associated with Moyamoya disease. There are also no cases associated with Moyamoya disease in 93 cases of persistent primitive hypoglossal artery (PHA) whose vascular anomaly is essentially similar to that of PTA. In the 907 cases of Moyamoya disease collected by Japanese cooperative study, there were no cases in which PTA or PHA was associated by. The period when PTA or PHA disappears at the embryonic stage (5-14 mm) almost corresponds to the period (11-14 mm) in which the vascular state is similar to Moyamoya phenomena. From this point of view, two cases of Moyamoya disease associated with PTA suggest that there is a close relationship between Moyamoya disease and PTA. On the other hand, it seems that Moyamoya disease is associated with PTA by mere chance, because their combination is very rare and Moyamoya vessels changes frequently and dynamically, while PTA does not change.
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PMID:[Moyamoya disease associated with persistent primitive trigeminal artery-Report of two cases]. 686 May 1


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