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[Clinical symptoms and diagnostic imaging in moyamoya disease]
Georgios Christopoulos1, Volker Ziegler, Günther Coblenz
1Institut für Diagnostische und Interventionelle Radiologie, Herz- und Gefässklinik GmbH, Bad Neustadt an der Saale. christopoulos.radiologie@herzchirurgie.de
Objective:
Presentation of typical imaging findings and diagnostic approaches in patients suspected of moyamoya disease.
Material And Methods:
Two female patients (24 resp. 44 years old) presenting with equivocal neurological symptoms (headache, recurrent monoparesis, choreiformic ataxia, grand mal seizure) were examined by means of colour-coded ultrasound, selective catheter-based angiography (DSA), CT and MRI including MR angiography.
Results:
Cranial CT and MRI showed normal findings in one patient, and focal cerebral infarctions of different age in the other. In both cases, colour-coded ultrasound was indicative in detecting occlusive disease of the internal carotid arteries. Both, MR angiography as well as catheter-based angiography revealed the pathology of the culprid vessel, in addition catheter-based angiography was more accurate in depicting moyamoya collaterals at the skull base.
Conclusion:
In moyamoya disease colour-coded ultrasound is diagnostic for the lesion of the internal carotid artery, MRI resp. MRA depict the vascular and parenchymal lesion, whereas catheter-based DSA by providing information about the main vessel and collateral system allows the staging of the disease.