AUTHOR=Edgell Randall , Boulos Alan S., Borhani Haghighi Afshin , Bernardini Gary L., Yavagal Dileep 

TITLE=Middle Cerebral Artery Stenosis Associated with Moyamoya Pattern Collateralization

JOURNAL=Frontiers in Neurology

VOLUME=Volume 1 - 2010

YEAR=2010

URL=https://www.frontiersin.org/journals/neurology/articles/10.3389/fneur.2010.00119

DOI=10.3389/fneur.2010.00119

ISSN=1664-2295

ABSTRACT=Background and Purpose:  Moyamoya disease is a well described phenomenon presenting with terminal internal carotid artery occlusion and rete pattern of collateralization around the occlusion. The development of moyamoya-like collaterals secondary to isolated middle cerebral artery stenosis or occlusion and the natural history of this entity in Caucasians have not been well described.  Methods:  Cerebral angiograms and CT angiograms performed between August 2004 and August of 2006 demonstrating moyamoya collateralization at a single US center were retrospectively reviewed. All cases of middle cerebral artery stenosis associated with a rete pattern of collateralization were included in this series. Demographic, clinical, and angiographic data were obtained.   Results:  There were 3 cases of middle cerebral artery stenosis associated with a moyamoya pattern of collateralization.  The average age of the patients was 36 years old, 2 were male, and all were Caucasian. All patients presented with ischemic symptoms.  The average degree of stenosis was 91%. No stenosis was seen in the supraclinoid internal carotid arteries or elsewhere in the intracranial vasculature.  Conclusion:  We describe a moyamoya-like pattern of anastomosis associated with isolated severe middle cerebral artery stenosis or occlusion in Caucasians.