Unilateral Moyamoya Disease in an Adolescent Female of Non-Asian Descent: A Case Report

Moyamoya disease is an idiopathic occlusive cerebrovascular disease that affects the internal carotid artery, middle cerebral artery or anterior cerebral artery forming a smoke-like collection of blood vessels seen on digital subtraction angiography or magnetic resonance imaging/angiography.Moyamoya disease most frequently occurs in East Asian populations and is worsened by physical stressors, often leading to headaches, seizures, speech/visual deficits, and transient ischemic attacks or strokes.The cause of moyamoya disease has yet to be fully explained, but several studies have shown genetics play a factor in the development of the disease.The characteristic puff of smoke sign is most easily visualized with direct angiography and can be treated surgically with direct or indirect revascularization techniques.This article presents a unique case of moyamoya disease in a Hispanic pediatric patient involving the left middle cerebral artery who was treated with an indirect revascularization technique, encephaloduroarteriosynangiosis.