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Intracerebral Hemorrhage due to Unilateral Moyamoya in a Young Woman during Puerperium
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| Author:
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POPPY SASMITA, HERLINA UINARNI, ROBI IRAWAN, TENA DJUARTINA, MASHURI, HULDANI
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| Abstract:
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Moyamoya disease is an uncommon cerebral vasculopathy associated with bilateral progressive steno-occlusion of the terminal internal carotid arteries with formation of collateral blood vessels. We present a case of a 26-year-old woman post-partum (1 month) with unilateral moyamoya, came to the hospital with severe headache and vomiting. Ten hours later patient looked loss of consciousness with Glasgow Coma Scale or GCS E2V2M4 and had weakness in the left limbs. Head Computed Tomography (CT) scan showed bleeding at right nucleus caudatus, right anterior crus of internal capsule with intraventricular hemorrhage (entire ventricular system) with minimal midline shift to the left. On examination Digital Subtraction Angiography (DSA) showed stenosis of the right distal internal carotid artery with "puff of smoke" appearance. Patients hospitalized for 17 days and went home with compos mentis and without weakness in the left limbs. After hospitalization, head CT Angiography was performed to evaluate the intracranial and extracranial blood vessels. Patient had cerebral bypass surgery procedure one month later. Six months after surgery, the patient was evaluated with head CT Angiography and showed normal brain parenchyma and brain perfusion. Although a rare case, intracerebral hemorrhage can caused by unilateral Moyamoya disease.
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| Keyword:
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DSA, GCS E2V2M4, Moyamoya disease.
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| EOI:
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| DOI:
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https://doi.org/10.31838/ijpr/2020.12.03.311
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| Download:
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