Moyamoya disease in an adult patient

Abstract

Moyamoya disease (MMD), is a cerebrovascular artery disease, generated by carotid arterie stenosis and their proximal intracranial branches (circle of Willis), with of perforating branches of ACI which dilate providing a collateral perfusion in the ischemic areas. Usually seen in the Japanese population, although it has been observed in other ethnic groups. Its clinical presentation in children encephalic strokes, which differs from adults, in which its main clinical presentation as intracranial hemorrhage, secondary to hyperflow generated in anomalous vessels which determines breakdown. Moyamoya vessels, are characterized showing luminal thrombosis and hyperplasia of smooth muscle cells, which in turn creates loss of elasticity in blood vessels and narrowing, subsequently the arterial intima will narrow and weakens as well as the small arteries are occluded by providing on-site training of thrombosis. The treatment consists in revascularization with direct bypass, where connect superficial temporal artery (ATS)- middle cerebral artery (MCA), or an indirect revascularization, by pial sinangiosis, encefalomiosinangiosis, encefaloduroarteriosinangiosis and encefaloduroarteriomiosinangiosis.