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Hyperhomocysteinemia in a Patient with Moyamoya Disease
Durga Shankar Meena1, Gopal Krishana Bohra1, Mahadev Meena1
1Department of Medicine, All India Institute of Medical Sciences, Jodhpur, Rajasthan, India.
Insights
This case report highlights a rare instance of moyamoya disease in an 18-year-old female with elevated homocysteine levels. Early diagnosis and conservative management with cobalamin and aspirin are crucial for such rare cerebrovascular conditions.
Area of Science:
- Neurology
- Vascular Medicine
- Genetics
Background:
- Moyamoya disease is a rare, progressive cerebrovascular disorder.
- It involves stenosis or occlusion of arteries at the circle of Willis.
- Thrombotic disorders are infrequently associated with moyamoya disease.
Observation:
- An 18-year-old female presented with recurrent headaches and vertigo.
- Cerebral angiography confirmed moyamoya disease.
- Thrombophilia testing revealed elevated homocysteine levels.
Findings:
- The patient was diagnosed with moyamoya disease and hyperhomocysteinemia.
- Conservative treatment with cobalamin and aspirin was initiated.
- Surgical revascularization was recommended.
Implications:
- This case underscores the importance of investigating thrombophilia in moyamoya disease patients.
- Elevated homocysteine may represent a contributing factor or a rare comorbidity.
- Further research is needed to elucidate the link between moyamoya disease and thrombotic conditions.
Abstract:
Moyamoya disease is a chronic progressive cerebrovascular disease characterized by bilateral occlusion or stenosis of arteries around circle of Willis. We report a case of 18-year-old female presented with recurrent episodes of headache and vertigo. On cerebral angiography, the patient was diagnosed to have moyamoya disease. On further evaluation, thrombophilia profile showed increased homocysteine level. The patient was treated conservatively with cobalamin and aspirin and advised for revascularization. According to the literature, there are few case reports of moyamoya disease with thrombotic disorders. Hence, we are reporting this interesting and rare case.
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