Moyamoya Disease in an adult female from Nepal: A case report.

Gurung, Suja; Gaire, Suman; Bajracharya, Aliza; Paudel, Anuj Krishna; Budhathoki, Pravash

Introduction and importance Moyamoya is a progressive vasoocclusive disease of large intracranial arteries with characteristic collaterals formation. It has a bimodal distribution and more frequent in females compared to males. Case presentation We present a case of 38 years female who presented with a loss of consciousness following headache. She was investigated with a head CT, cerebral angiogram, and digital subtraction angiography which led to a diagnosis of Moyamoya disease. She was treated conservatively and scheduled for follow-up. Clinical discussion Although ischemic attacks are the common presenting symptoms in cases of Moyamoya disease, hemorrhagic forms are seen too especially among adults compared to children. Identifying Moyamoya disease can significantly affect the treatment options and give insight into managing the chronic nature of the disease to both the physicians and patients. Conclusion This case highlights the importance of searching for underlying cause in a young female presenting with intracranial haemorrhage for the first time and keeping Moyamoya disease as a differential.