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Idiopathic steno-occlusive disease with bilateral internal carotid artery occlusion: A Case Report
BACKGROUND: Moyamoya disease (MMD) is a rare cause of acute stroke and transient ischemic attacks in children. We described clinical, diagnostic features and follow-ups of a young child with acute stroke. CASE SUMMARY: We report a 4-year-old girl with left hemiparesis after an acute ischemic stroke....
Autores principales: | , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Baishideng Publishing Group Inc
2023
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10198089/ https://www.ncbi.nlm.nih.gov/pubmed/37215413 http://dx.doi.org/10.12998/wjcc.v11.i13.3076 |
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author | Hamed, Sherifa Ahmed Yousef, Hosam Abozaid |
author_facet | Hamed, Sherifa Ahmed Yousef, Hosam Abozaid |
author_sort | Hamed, Sherifa Ahmed |
collection | PubMed |
description | BACKGROUND: Moyamoya disease (MMD) is a rare cause of acute stroke and transient ischemic attacks in children. We described clinical, diagnostic features and follow-ups of a young child with acute stroke. CASE SUMMARY: We report a 4-year-old girl with left hemiparesis after an acute ischemic stroke. Her history was also significant for repeated left or right focal motor seizures, generalized tonic-clonic convulsions and transient ischemic attacks. Her magnetic resonance imaging and computed tomography (CT) of the brain and magnetic resonance angiography, CT angiography and venography on the cerebral vessels revealed evidence of bilateral fronto-parietal ischemic infarctions, occlusion of the right and left internal carotid arteries started at its bifurcation and non-visualization of right and left anterior and middle cerebral arteries. There was evidence of progression in angiography manifested as development of collaterals from the basal perforating vessels, increase in the extent of large intracranial arterial stenosis/occlusion and extensive collateral circulation with predominance from the posterior circulation. Physical and neurological evaluation and comprehensive laboratory investigations excluded an obvious comorbid disease or risk factor for the child’s condition. The diagnosis of MMD was highly suggested as a cause of the child’s steno-occlusive condition. She was treated symptomatically with levetiracetam, an antiepileptic medication. Aspirin was prescribed for secondary prevention. Her clinical manifestations were improved during the three years of follow-up. Revascularization surgery was postponed. CONCLUSION: Up to our knowledge, this is the first report for MMD in a child in our country. The clinical improvement and the stabilization of the child’s condition over the 3 years of follow-up could be attributed to the rapid and extensive recruitment of collaterals and absence of risk factors or comorbidities. Revascularization surgery is highly recommended. |
format | Online Article Text |
id | pubmed-10198089 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2023 |
publisher | Baishideng Publishing Group Inc |
record_format | MEDLINE/PubMed |
spelling | pubmed-101980892023-05-20 Idiopathic steno-occlusive disease with bilateral internal carotid artery occlusion: A Case Report Hamed, Sherifa Ahmed Yousef, Hosam Abozaid World J Clin Cases Case Report BACKGROUND: Moyamoya disease (MMD) is a rare cause of acute stroke and transient ischemic attacks in children. We described clinical, diagnostic features and follow-ups of a young child with acute stroke. CASE SUMMARY: We report a 4-year-old girl with left hemiparesis after an acute ischemic stroke. Her history was also significant for repeated left or right focal motor seizures, generalized tonic-clonic convulsions and transient ischemic attacks. Her magnetic resonance imaging and computed tomography (CT) of the brain and magnetic resonance angiography, CT angiography and venography on the cerebral vessels revealed evidence of bilateral fronto-parietal ischemic infarctions, occlusion of the right and left internal carotid arteries started at its bifurcation and non-visualization of right and left anterior and middle cerebral arteries. There was evidence of progression in angiography manifested as development of collaterals from the basal perforating vessels, increase in the extent of large intracranial arterial stenosis/occlusion and extensive collateral circulation with predominance from the posterior circulation. Physical and neurological evaluation and comprehensive laboratory investigations excluded an obvious comorbid disease or risk factor for the child’s condition. The diagnosis of MMD was highly suggested as a cause of the child’s steno-occlusive condition. She was treated symptomatically with levetiracetam, an antiepileptic medication. Aspirin was prescribed for secondary prevention. Her clinical manifestations were improved during the three years of follow-up. Revascularization surgery was postponed. CONCLUSION: Up to our knowledge, this is the first report for MMD in a child in our country. The clinical improvement and the stabilization of the child’s condition over the 3 years of follow-up could be attributed to the rapid and extensive recruitment of collaterals and absence of risk factors or comorbidities. Revascularization surgery is highly recommended. Baishideng Publishing Group Inc 2023-05-06 2023-05-06 /pmc/articles/PMC10198089/ /pubmed/37215413 http://dx.doi.org/10.12998/wjcc.v11.i13.3076 Text en ©The Author(s) 2023. Published by Baishideng Publishing Group Inc. All rights reserved. https://creativecommons.org/licenses/by-nc/4.0/This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. |
spellingShingle | Case Report Hamed, Sherifa Ahmed Yousef, Hosam Abozaid Idiopathic steno-occlusive disease with bilateral internal carotid artery occlusion: A Case Report |
title | Idiopathic steno-occlusive disease with bilateral internal carotid artery occlusion: A Case Report |
title_full | Idiopathic steno-occlusive disease with bilateral internal carotid artery occlusion: A Case Report |
title_fullStr | Idiopathic steno-occlusive disease with bilateral internal carotid artery occlusion: A Case Report |
title_full_unstemmed | Idiopathic steno-occlusive disease with bilateral internal carotid artery occlusion: A Case Report |
title_short | Idiopathic steno-occlusive disease with bilateral internal carotid artery occlusion: A Case Report |
title_sort | idiopathic steno-occlusive disease with bilateral internal carotid artery occlusion: a case report |
topic | Case Report |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10198089/ https://www.ncbi.nlm.nih.gov/pubmed/37215413 http://dx.doi.org/10.12998/wjcc.v11.i13.3076 |
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