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.

Related Concept Videos

Inflammatory Bowel Disease II: Crohn's Disease01:30

Inflammatory Bowel Disease II: Crohn's Disease

Introduction
Inflammatory bowel disease, commonly known as IBD, refers to a collection of disorders that lead to persistent inflammation of the gastrointestinal tract. The two types of IBD are ulcerative colitis, which impacts the colon, and Crohn's disease, which can involve any part of the gastrointestinal segment.
Crohn's disease
Crohn's disease is a chronic, systemic inflammatory bowel disease (IBD) that predominantly affects the gastrointestinal tract. It is marked by...
1.2K
Patient-centered Care01:13

Patient-centered Care

Patient-centered care involves delivering care beyond inpatient hospitalization. Reflective practice can enhance a patient-centered approach. Reflective practice is a process of reasoning that considers all aspects of the present situation, including practicalities, learning from personal practice, and consideration of patient needs. Patients appreciate care decisions made while considering their input. Involving the patient in their care provides the patient with a sense of contribution rather...
3.1K
Immunodeficiency Diseases01:25

Immunodeficiency Diseases

Immunodeficiency disorders are conditions in which the immune system's ability to fight infectious disease and cancer is compromised or entirely absent. The immune system comprises a complex network of cells, tissues, and organs that work together to protect the body from potentially harmful invaders. When this system is deficient or not functioning properly, it leaves the body susceptible to infections, diseases, or other complications.
There are three main causes of immunodeficiency...
2.5K
Drug Dosing: Geriatric Patients01:15

Drug Dosing: Geriatric Patients

Elderly individuals encompass a diverse population with varying degrees of age-related physiological changes. Defining the elderly presents challenges, as the geriatric population is often arbitrarily categorized as individuals older than 65. However, many individuals in this group lead active and healthy lives, with an increasing number surpassing 85 years and falling into the older elderly category. Physiological changes associated with aging impact performance capacity and homeostatic...
278
Parkinson's Disease: Treatment01:24

Parkinson's Disease: Treatment

Neurodegenerative disorders, such as Parkinson's Disease (PD), involve the gradual and irreversible destruction of neurons in particular brain areas. These disorders exhibit standard features like proteinopathies, selective vulnerability of some neurons, and an interaction of intrinsic properties, genetics, and environmental influences in neural injury.
Parkinson's Disease is primarily a result of the loss of dopaminergic neurons in the substantia nigra pars compacta. The cornerstone of...
1.2K
Alzheimer's Disease: Treatment01:22

Alzheimer's Disease: Treatment

Alzheimer's Disease (AD), a neurodegenerative disorder, is pathologically identified by amyloid plaques and neurofibrillary tangles composed of tau protein. AD pharmacotherapy aims to manage cognitive symptoms, delay disease progression, and treat behavioral symptoms. The treatment is primarily symptomatic and palliative, with no definitive disease-modifying therapy available. Cholinesterase inhibitors, including donepezil (Aricept), rivastigmine (Exelon), and galantamine (Razadyne), are...
968