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[Cerebrovascular moyamoya disease associated with basilar aneurysm (author's transl)]
Abstract:
Two adult cases of cerebrovascular Moyamoya disease, associated with basilar aneurysm are reported. At the follow-up study of angiogram performed 14 months later in one case, the aneurysmal shadow was slightly larger than before. In the other case, craniotomy was performed and two aneurysms were confirmed to be the saccular aneurysms arising from the basilar head and superior cerebellar artery junction, respectively. From these facts, it is suggested that these aneurysms were not pseudo-aneurysms but sacuular aneurysms. As for the pseudo-aneurysm associated with cerebrovascular Moyamoya disease, we discussed in our previous report. It has been generally through that the mechanism of the occurence of symptoms in adult patient with cerebrovascular Moyamoya disease is due to rupture of abnormal vessels in the subarachnoid space. But from our experiences, it is suggested that there should be another mechanicsm, which begins with rupture of these basilar aneurysms. In addition to that, the growing mechanisms of basilar aneurysm associated with cerebrovascular Moyamoya disease is discussed.
Insights
This study reports two adult cases of Moyamoya disease with basilar aneurysms, suggesting their rupture may cause symptoms, not just abnormal vessels. Further research into aneurysm growth mechanisms is discussed.
Area of Science:
- Neurology
- Vascular Surgery
Background:
- Moyamoya disease is a rare cerebrovascular disorder characterized by progressive stenosis of the internal carotid arteries.
- Adult patients with Moyamoya disease often present with symptoms attributed to the rupture of abnormal vessels in the subarachnoid space.
Observation:
- Two adult cases of Moyamoya disease associated with basilar aneurysms were analyzed.
- Follow-up angiograms showed aneurysm enlargement in one case.
- Surgical confirmation identified saccular aneurysms at the basilar artery and superior cerebellar artery junction in the other case.
Findings:
- The reported aneurysms were confirmed as saccular, not pseudo-aneurysms.
- The findings suggest that rupture of these basilar aneurysms, rather than abnormal vessels alone, may be a primary mechanism for symptom onset in adult Moyamoya disease.
- The growth mechanisms of basilar aneurysms in Moyamoya disease were investigated.
Implications:
- This challenges the traditional understanding of Moyamoya disease symptomology in adults.
- Highlights the importance of considering and monitoring basilar aneurysms in Moyamoya disease patients.
- Suggests potential new therapeutic targets and diagnostic approaches for Moyamoya disease.