A case of moyamoya disease with a transient neurological deterioration associated with subcortical low intensity on fluid-attenuated inversion recovery magnetic resonance images after bypass surgery.
World Neurosurg. 2015 Dec 15;
Authors: Tanioka S, Shiba M, Umeda Y, Sano T, Maeda M, Suzuki H
Abstract
BACKGROUND: Moyamoya disease is often treated by revascularization surgery. In this report, we first describe a case of moyamoya disease, which repeatedly showed a transient subcortical low intensity (SCLI) on fluid-attenuated inversion recovery (FLAIR) magnetic resonance images postoperatively.
CASE DESCRIPTION: A 59-year-old woman presenting with repeated transient ischemia underwent right superficial temporal artery to middle cerebral artery anastomosis with encephalo-duro-myo-synangiosis. After the operation, the patient had a transient neurological deterioration. MRI findings were not particular apart from SCLI and sulcal hyperintensity on FLAIR images, but no abnormalities in cerebral blood flow on SPECT and no abnormalities on electroencephalogram were found. Symptoms improved in a few days, and SCLI on FLAIR images disappeared in a few months. Thereafter, when the left-sided bypass surgery was performed, similar findings occurred in the left cerebral hemisphere.
CONCLUSIONS: The mechanisms of transient SCLI on FLAIR images remain unclear, but this finding appears to be associated with a postoperative transient neurological deterioration.
PMID: 26704214 [PubMed - as supplied by publisher]
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