Moyamoya disease with mesial temporal sclerosis

Area of Science:

• Neurology
• Neurosurgery
• Pediatric Neurology

Background:

• Moyamoya syndrome and mesial temporal sclerosis (MTS) are distinct neurological conditions.
• The co-occurrence of symptomatic MTS and progressive moyamoya syndrome is unprecedented.
• MTS often necessitates future surgical intervention, posing challenges with concurrent moyamoya revascularization.

Observation:

• A 5-year-old boy presented with symptomatic mesial temporal sclerosis (MTS).
• The patient subsequently developed progressive moyamoya syndrome.
• This dual pathology created a complex clinical scenario requiring careful surgical consideration.

Findings:

• A novel, combined one-day surgical approach was employed.
• The procedure involved resection of the right inferior and mesial temporal lobe.
• Simultaneously, right pial synangiosis was performed for moyamoya syndrome.
• The patient experienced a successful recovery without neurological deficits.

Implications:

• This case highlights the importance of strategic surgical planning in managing patients with coexisting, complex neurological conditions.
• The successful combined procedure offers a potential model for similar rare pediatric cases.
• It underscores the need for multidisciplinary approaches in neurosurgery for rare disease combinations.