Summary
The case of a 52 year old white female is presented in whom the first carotid angiogram showed a stenosis of the carotid siphon and an occlusion of most branches of the Sylvian group. The lenticulostriate arteries were patent. 23 months later the angiogram of the major arteries was similar with the exception of nonfilling of the anterior cerebral artery. Moreover the lenticulostriate arteries were replaced by bundles of larger corkscrewlike (Moyamoya) arteries that run from the base into the centrum semiovale, where they connect with the parieto-occipital cortical supply. This case proves the aquired formation of such systems typical of Moyamoya disease and is discussed in detail.
Résumé
Les auteurs présentent le cas d'une femme blanche de 52 ans qui, lors de la première angiographie carotidienne, a présenté une sténose du siphon carotidien avec occlusion de la plupart des branches du groupe sylvien. Les artères lenticulostriées étaient présentes. Un contrôle angiographique 23 mois plus tard montra un état identique des principales artères avec non opacification de l'artère cérébrale antérieure. De plus, les artères lenticulostriées étaient remplacées par des paquets d'artères en tire-bouchon plus grosses (de type Moyamoya) qui s'étendaient de la base dans le centre semi-ovale où elles s'anastomosaient avec les artères corticales pariéto-occipitales. Ce cas démontre le développement acquis du système typique de Moya-Moya.
Zusammenfassung
Fallbeschreibung einer 52jährigen Patientin, bei der die erste Carotisarteriographie eine Stenose im Bereich des Carotis-Siphon und einen Verschluß im Bereich der A. cerebri media zeigte. Eine weitere Untersuchung 23 Monate später ließ eine extreme Aufweitung und Schlängelung der Lenticulostriata-Arterien erkennen im Sinne einer Moyamoya-Erkrankung. Ausführliche Beschreibung dieses Leidens.
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References
Andrioli, G. C., Marin, G., Carteri, A.: Considerazioni sull'ipoplasia della carotide interna associata a pseudoangiomatosi cerebrale. Atti del 2. Simposio Internazionale di Neurochirurgia, Acquaviva dell Fonti, p. 41–48, 3. Nov. 1971
Balbo, R. J., Sarian, L., Sperlescu, A., Ribeiro, L. A. O.: Doenca oclusiva progressiva das arterial cerebrais (“Moya-Moya”). Seara Med. Neuroc. (São Paulo) 1, 168–173 (1972)
Decker, J.: Klinische Neuroradiologie. Stuttgart: Thieme 1960
Dumas, M., Girard, P. L., Collomb, H.: Occlusions bilatérales de la carotide interne associée à une circulation de suppléance cortico-corticale, transdurale, et du type “Moya-Moya” chez l'enfant noir. J. neurol. Sci. 16, 1–25 (1972)
Galligioni, F., Andrioli, G. C., Marin, G., Briani, S., Iraci, G.: Hypoplasia of the internal carotid artery associated with cerebral pseudoangiomatosis. Amer. J. Roentgenol. 112, 251–262 (1971)
Gerlach, J.: Pädiatrische Neurochirurgie. Stuttgart: Thieme 1967)
Handa, J., Handa, H.: Progressive cerebral arterial occlusive disease: Analysis of 27 cases. Neuroradiology 3, 199–133 (1972)
Krayenbühl, H., Yasargil, M.: Die cerebrale Angiographie. Stuttgart: Thieme 1965
Kudo, T.: Insufficiency of the circle of Willis. The Annual Meeting of Japanese Society of Neurology, 1963
Kudo, T.: Juvenile occlusion of the circle of Willis. Clin. Neurol. 5, 607–627 (1965)
Kudo, T.: Juvenile occlusion of the circle of Willis. Proc. 8th Int. Congr. Neurol. 4, 503 (1966)
Kudo, T.: Spontaneous occlusion of the circle of Willis. A disease apparently confined to Japanese. Neurology (Minneap.) 18, 485–496 (1968)
Leeds, N. E., Abbott, K. B.: Collateral circulation in cerebrovascular disease in childhood via rete mirabile and perforating branches of anterior chorioidal and posterior cerebral arteries. Radiology 85, 628–634 (1965)
Maki, Y., Nakata, Y.: An autopsy case of hemangiomatous malformation of bilateral internal carotid artery at the base of brain. Brain Nerve (Tokyo) 17, 764–766 (1965)
Merrit, H. H.: cit. by Suzuki and Takaku, 1969
Nishimoto, A., Sugiu, R.: Hemangiomatous malformation of bilateral internal carotid artery at the base of brain. Preliminary report. Proc. of the Annual meeting of the Neuroradiological Association of Japan, Tokyo, No. 5, 2–9 (1964)
Suzuki, J., Kodama, N.: Cerebrovascular “Moyamoya” Disease. Second Report: collateral routes to forebrain via ethmoid sinus and superior nasal meatus. Angiology 22, 223–236 (1971)
Suzuki, J., Takaku, A.: Cerebrovascular “moyamoya” disease. A disease showing abnormal netlike vessels in base of brain. Arch. Neurol. 20, 288–299 (1969)
Suzuki, J., Takaku, A., Asahi, M.: Diseases whowing the “fibrille” like vessels at the base of brain (frequently found in the Japanese). Brain Nerve (Tokyo) 17, 767–776 (1965)
Suzuki, J., Takaku, A., Asahi, M.: The disease showing the abnormal vascular net-work at the base of brain, particularly found in Japan: II. A follow-up study. Brain Nerve (Tokyo) 18, 897–908 (1966)
Suzuki, J.: The disease showing the abnormal vascular net-work at the base of brain particularly found in Japan (cerebro-vascular “Moyamoya” disease). IV. Our opinion of the dynamic change of these vascular net-works. Brain Nerve (Tokyo) 20, 35–40 (1968)
Takeuchi, K.: Occlusive diseases of the carotid artery. Recent advances in research of the nervous system, 5, 511–513 (1961)
Taveras, J. M.: Multiple progressive intracranial arterial occlusion. A syndrome of Children and young adults. J. Amer. Roentgenol. 106, 235–268 (1969)
Taveras, J. M., Wood, E. H.: Diagnostic neuroradiology. Baltimore: Williams and Wilkins 1964
Weibel, J., Fields, W. S.: Atlas of arteriography in occlusive cerebrovascular disease. Stuttgart: Thieme 1969
Weidner, W., Hanafee, W., Markhan, C. H.: Intracranial collateral circulation via leptomeningeal and rete mirabile anastomoses. Neurology 15, 39–48 (1965)
Zülch, K. J.: Allgemeine Prinzipien bei der Entschung der Kollateralkreisläufe der Hirnarterien. Radiologe 9, 396–406 (1969)
Zülch, K. J.: Some basic patterns of the collateral circulation of the cerebral atteries. In: Cerebral circulation and stroke, Zülch, K. J. (ed.) pp. 106–122. Berlin-Heidelberg-New York: Springer-Verlag 1971
Zülch, K. J., v. Einsiedel-Lechtape, H., Hartmann, W.: Die Klinik des Verschlusses der A. cerebri media. XXVI Giornate Mediche Trieste, 1972. Journées méd. France 1973 (in press)
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Zülch, K.J., Dreesbach, H.A. & Eschbach, O. Occlusion of the middle cerebral artery with the formation of an abnormal arterial collateral system—Moyamoya type-23 months later. Neuroradiology 7, 19–24 (1974). https://doi.org/10.1007/BF00344670
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DOI: https://doi.org/10.1007/BF00344670