Specific learning disorder in mathematics and moyamoya disease: A case report

Moyamoya disease (MMD) is a rare neurological condition that causes impaired blood flow to the brain, transient ischemic attacks or strokes, and accompanying cognitive impairments, especially in executive functioning. There is little data on the impact of this rare condition on academic outcomes in late childhood and adolescence. Here, we present the case of Ms. X, a 17-year-old white female diagnosed with MMD, who presented with evidence of a specific learning disorder (SLD) in mathematics. Ms. X was diagnosed with MMD at 6 years old and underwent revascularization surgery. Though she recovered well and progressed adequately in home schooling, she and her mother noticed a decline in memory and academic performance around 16 years old, prompting a neuropsychological evaluation. Cognitive testing revealed low average overall cognitive abilities with impaired planning and organizational skills. While her reading and spelling skills were consistent with her 10th grade academic level, she scored in the 1st percentile on the WRAT-5 Math Computation section, and her mathematical skills were estimated to be at a 2nd grade level. This case adds to the literature by documenting a specific area of academic deficit in an adolescent with MMD. The case highlights that individuals with MMD, especially those with similar executive deficits, may experience selective learning challenges in mathematics. Children with MMD may benefit from specialized academic services and interventions in specific areas of difficulty.