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Moyamoya disease with posterior communicating artery aneurysm: a case report

Luo Qi1, Yu Jinlu

  • 1First Hospital of Jilin University, Department of Neurosurgery, Changchun, China.

Turkish Neurosurgery
|October 9, 2013
PubMed

Insights

Moyamoya disease patients with rare posterior communicating artery aneurysms can have good outcomes even if the internal carotid artery is occluded post-treatment, thanks to strong collateral circulation.

Area of Science:

  • Neurology
  • Vascular Surgery
  • Radiology

Background:

  • Moyamoya disease (MMD) is a rare cerebrovascular disorder characterized by progressive stenosis of the internal carotid arteries.
  • Aneurysms in the proximal posterior communicating artery (PcomA) are an uncommon complication in MMD patients.

Observation:

  • A middle-aged female MMD patient presented with a ruptured wide-necked aneurysm at the proximal PcomA, supplying the posterior cerebral artery (PCA).
  • Endovascular treatment involving stent-assisted coil embolization led to unintended occlusion of the internal carotid artery (ICA) and PcomA.

Findings:

  • Despite ICA and PcomA occlusion, the patient demonstrated significant improvement and no complications due to robust collateral circulation.
  • One-year follow-up digital subtraction angiography (DSA) confirmed no aneurysm recurrence and persistent adequate collateral blood flow.

Implications:

  • This case highlights that accidental ICA and PcomA occlusion during endovascular treatment for MMD-associated PcomA aneurysms may not lead to poor prognosis.
  • Sufficient collateral circulation is a critical factor for favorable outcomes in MMD patients undergoing complex endovascular procedures.

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