Moyamoya Disease Presented With Migrainelike Headache in a 4-Year-Old Girl

Abstract

A 4-year-old girl was admitted to our department with the complaints of severe headache, nausea, vomiting, and photophobia. She had a 1-year history of migrainelike headache that occurred every 1 to 2 months. Her neurologic examination was normal, but T₂-weighted axial magnetic resonance imaging (MRI) of the brain showed flow void within the basal ganglia owing to parenchymal vascular collaterals. Magnetic resonance angiography and digital substraction carotid angiography showed both occlusion of the internal carotid artery in the supraclinoid portion and extensive parenchymal vascular collaterals. Because there was no evidence of risk factors for cerebral arterial occlusion and cerebral infarct or hemorrhage, she was diagnosed as having moyamoya disease. In any case of atypical migrainelike headache, a detailed investigation should be kept in mind to detect an underlying vascular disease such as moyamoya. (J Child Neurol 2003;18:361—363).

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References

De Veber G. : Cerebrovascular disease in children, in Swaiman KF , Ashwal S (eds): Pediatric Neurology Principles and Practice, 3rd ed. St Louis, Mosby, Inc, 1999, 1099—1124.

Chiu D. , Shedden P. , Bratina P. , Grotta JC : Clinical features of moyamoya disease in the United States. Stroke 1998;29:1347—1351.

Fukui M. , Kono S. , Sueishi K. , Ikezaki K. : Moyamoya disease. Neuropathology 2000;20(Suppl):S61—S64.

Dai AI , Shaikh ZA , Cohen ME : Early-onset moyamoya syndrome in a patient with Down syndrome: Case report and review of the literature. J Child Neurol 2000;15:696—699.

Lutterman J. , Scott M. , Nass R. , Geva T. : Moyamoya syndrome associated with congenital heart disease. Pediatrics 1998;101:57—60.

Goutieres F. , Bourgeois M. , Trioche P. , et al: Moyamoya disease in a child with glycogen storage disease type Ia. Neuropediatrics 1997;28:133—134.

El Ramahi KM , Al Rayes HM : Systemic lupus erythematosus associated with moyamoya syndrome. Lupus 2000;9:632—636.

Serdaroğlu A. , Simsek F. , Gucuyener K. , et al: Moyamoya syndrome after radiation therapy for optic pathway glioma: Case report. J Child Neurol 2000;15:765—767.

Renda Y. , Gucuyener K. , Ozen H. , Topçu M. : Moyamoya disease and alternating hemiplegia: A report of two cases. Turk J Pediatr 1993;35: 283—289.

10.

Park-Matsumoto YC , Tazawa T. , Shimizu J. : Migraine with aura-like headache associated with moyamoya disease. Acta Neurol Scand 1999 ;100:119—121.

11.

Bernstein AL : Hemiplegic migraine and moyamoya disease. Am J Dis Child 1993;147:718—719.

12.

Imaizumi C. , Imaizumi T. , Osawa M. , et al: Serial intelligence test scores in pediatric moyamoya disease. Neuropediatrics 1999;30:294—299.

13.

Hosain SA , Hughes JT , Forem SL , et al: Use of a calcium channel blocker (nicardipine HCl) in the treatment of childhood moyamoya disease. J Child Neurol 1994;9:378—380.