Middle cerebral artery stenosis associated with moyamoya pattern collateralization.

Area of Science:

• Neurology
• Vascular Neurology
• Radiology

Background:

• Moyamoya disease is a recognized cerebrovascular condition.
• The specific collateralization pattern linked to isolated middle cerebral artery stenosis is not well-documented.
• The natural history of this specific presentation remains unclear.

Purpose of the Study:

• To describe an unusual collateralization pattern.
• To investigate its association with isolated middle cerebral artery (MCA) stenosis.
• To characterize the demographic, clinical, and angiographic features of affected individuals.

Main Methods:

• Retrospective review of cerebral angiograms and CT angiograms from August 2004 to August 2006.
• Inclusion criteria: moyamoya collateralization with middle cerebral artery stenosis.
• Data collected included demographics, clinical presentation, and angiographic details.

Main Results:

• Three cases of isolated middle cerebral artery stenosis with moyamoya collateralization were identified.
• Patients were Caucasian, with an average age of 36; two were male.
• All presented with ischemic symptoms, and demonstrated an average of 91% MCA stenosis without other intracranial vascular abnormalities.

Conclusions:

• This study highlights an uncommon anastomosis pattern associated with severe, isolated middle cerebral artery stenosis or occlusion.
• The findings are specific to Caucasian patients.
• Further research is warranted to understand the implications of this specific moyamoya pattern.