The use of vessel wall imaging to detect a de novo microaneurysm on the periventricular anastomoses in moyamoya disease: illustrative case.

Autor:	Ninomiya A; 1Department of Neurosurgery, Kohnan Hospital, Sendai, Miyagi, Japan.; 2Department of Neurosurgery, Tohoku University Graduate School of Medicine, Sendai, Miyagi, Japan; and., Endo H; 1Department of Neurosurgery, Kohnan Hospital, Sendai, Miyagi, Japan.; 3Division of Advanced Cerebrovascular Surgery, Tohoku University Graduate School of Medicine, Sendai, Miyagi, Japan., Tashiro R; 2Department of Neurosurgery, Tohoku University Graduate School of Medicine, Sendai, Miyagi, Japan; and., Kanoke A; 1Department of Neurosurgery, Kohnan Hospital, Sendai, Miyagi, Japan., Tominaga T; 2Department of Neurosurgery, Tohoku University Graduate School of Medicine, Sendai, Miyagi, Japan; and.
Jazyk:	angličtina
Zdroj:	Journal of neurosurgery. Case lessons [J Neurosurg Case Lessons] 2023 Mar 20; Vol. 5 (12). Date of Electronic Publication: 2023 Mar 20 (Print Publication: 2023).
DOI:	10.3171/CASE2365
Abstrakt:	Background: Moyamoya disease (MMD) is linked to the formation of intracranial aneurysms. The authors recently observed an effective use of magnetic resonance vessel wall imaging (MR-VWI) to detect de novo unruptured MMD-associated microaneurysms. Observations: The authors describe a 57-year-old female who was diagnosed with MMD 6 years ago after suffering a left putaminal hemorrhage. MR-VWI revealed point-like enhancement in the right posterior paraventricular region during the annual follow-up. On the T2-weighted image, this lesion was surrounded by high intensity. Angiography revealed a microaneurysm in the periventricular anastomosis. Right combined revascularization surgery was performed to prevent future hemorrhagic events. Another de novo circumferential enhanced lesion on MR-VWI appeared in the left posterior periventricular region 3 months after surgery. Angiography revealed that the enhanced lesion was a de novo microaneurysm on the periventricular anastomosis. The left combined revascularization surgery went well. The bilateral microaneurysms vanished on follow-up angiography. Lessons: Unruptured MMD-associated microaneurysms on the periventricular anastomosis can be detected using MR-VWI. Revascularization surgery can eliminate microaneurysms by reducing hemodynamic stress on the periventricular anastomosis.
Databáze:	MEDLINE
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