[P1-214] Moyamoya disease presented with psychological and behavioral abnormalities in a 3 years old girl --- a case report
Objective Moyamoya disease is a chronic cerebral vascular disease characterized by progressive occlusion of the cerebral arteries resulting in the development of abnormal collateral circulation. The clinical manifestations are mainly cerebral ischemia, cerebral hemorrhage, and seizures. We present a case of moyamoya disease with psychological and behavioral abnormalities as the first clinical manifestation.
Methods and Results A 3 years old girl was admitted to our department with the complaints of psychological and behavioral abnormalities, which manifested as disability to recognize parents, refusing to eat and sleep, breaking things, irritability noisy crying, and incontinence. The magnetic resonance imaging (MRI) showed bilateral extensive cerebral white matter hyperintensity, flow void visualization in the reinforcing phase and the magnetic resonance angiography (MRA) indicated obliteration of both middle cerebral arteries, multiple circuitous and dilated capillaries around the Willis ring and basal ganglia region. Because there was no evidence of risk factors for cerebral arterial occlusion and cerebral infarct or hemorrhage, she was diagnosed as having moyamoya disease.
Conclusion: Our case report has reported a moyamoya disease with psychological and behavioral abnormalities as the first clinical manifestation in the 3 years old girl. Bilateral extensive cerebral white matter hyperintensity may also be a part of moyamoya disease, and pediatrics should make a thorough evaluation so as not to delay in diagnosing preexisting moyamoya disease.
Methods and Results A 3 years old girl was admitted to our department with the complaints of psychological and behavioral abnormalities, which manifested as disability to recognize parents, refusing to eat and sleep, breaking things, irritability noisy crying, and incontinence. The magnetic resonance imaging (MRI) showed bilateral extensive cerebral white matter hyperintensity, flow void visualization in the reinforcing phase and the magnetic resonance angiography (MRA) indicated obliteration of both middle cerebral arteries, multiple circuitous and dilated capillaries around the Willis ring and basal ganglia region. Because there was no evidence of risk factors for cerebral arterial occlusion and cerebral infarct or hemorrhage, she was diagnosed as having moyamoya disease.
Conclusion: Our case report has reported a moyamoya disease with psychological and behavioral abnormalities as the first clinical manifestation in the 3 years old girl. Bilateral extensive cerebral white matter hyperintensity may also be a part of moyamoya disease, and pediatrics should make a thorough evaluation so as not to delay in diagnosing preexisting moyamoya disease.