A Rare Case of Moyamoya Disease in Infancy: Complexities in Post-stroke Neurorehabilitation

Area of Science:

• Pediatric Neurology
• Vascular Neurology
• Rare Diseases

Background:

• Ischemic stroke in infants, though uncommon, contributes significantly to childhood morbidity and mortality.
• Moyamoya disease is a rare, progressive cerebrovascular disorder characterized by stenosis of the terminal portion of the internal carotid artery and development of collateral circulation.
• This condition is particularly underdiagnosed in regions like Morocco due to limited access to advanced diagnostic tools.

Observation:

• This case report details a four-month-old infant diagnosed with ischemic stroke secondary to Moyamoya disease.
• The infant presented with diverse clinical symptoms, complicating timely diagnosis.
• Diagnostic delays were attributed to the lack of advanced neuroimaging (MRI, angiography) and limited pediatric neurological expertise.

Findings:

• Moyamoya disease poses significant diagnostic hurdles in infants due to varied clinical presentations and limited access to neuroimaging.
• Rehabilitation management is further complicated by the absence of standardized international protocols and dedicated pediatric rehabilitation facilities in resource-limited settings.
• Delayed diagnosis directly impacts the effectiveness of interventions and long-term prognosis.

Implications:

• Highlights the critical need for increased awareness and accessibility of neuroimaging for early Moyamoya disease diagnosis in infants.
• Emphasizes the necessity for developing standardized pediatric stroke and Moyamoya rehabilitation protocols adaptable to resource-limited environments.
• Underscores the importance of establishing pediatric rehabilitation structures to address the unique needs of children with rare cerebrovascular diseases.