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Journal of Korean Neurosurgical Society 1981;10(2): 613-618.
A Case of Moyamoya Disease with Intracranial Aneurysm.
Hoon Kap Lee, Soon Goo Jo, Ki Chan Lee, Jeong Wha Chu
Department of Neurosurgery, College of Medicine, Korea University, Seoul, Korea.
Moyamoya disease is a particular disease of the circle of Willis which is characterized by its progressive obstruction and associated with different cerebral vascular malformations and infrequently associated with aneurysms. A 23 year old Korean woman was admitted to the Department of Neurosurgery, Korea University Hospital, because of stuporous mentality and Rt. Sided hemiplegia. She fell down and almost immediately lost consciousness on the day morning of admission. Neurological findings included neck stiffness, moderately bilateral dilated pupils, Rt. Sided hemiplegia, positive bilateral Babinski's sign and positive Kernig's sign. Lumbar angiogram revealed grossly bloody cerebrospinal fluid. Carotid angiogram revealed marked stenosis of supraclinoid portion of intracranial internal carotid arteries with extensive collateral small arterial net work at the base of the brain. Small aneurismal sac was visualized at the distal end of the small arterial nerwork probably distal portion of posterior choroidal artery. Brain computed tomography showed hematoma at the posterior portion of left side thalamic area and in the left lateral ventricle. The patient had operation for removal of hematoma and died on the 2nd day of postoperation. Based on this case, mechanisms of formation of aneurysms in moyamoya disease are discussed.
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