Moya-Moya syndrome after cranial radiation for optic glioma with NF1. Case report and literature review of syndromic cases

Neurochirurgie. 2018 Mar;64(1):63-67. doi: 10.1016/j.neuchi.2017.11.004. Epub 2018 Feb 21.

Abstract

Introduction: Moya-Moya angiopathy is a neurovascular disease that predisposes to ischemic or hemorrhagic strokes. It is generated by a steno-occlusion of the terminal portion of the internal carotid arteries, which induces the development of abnormal neovessels in the deep regions of the brain. Some pathologies such as sickle cell disease, Down syndrome or Graves' disease may be associated with Moya-Moya angiopathy. These syndromic forms harbor several differences compared with idiopathic Moya-Moya disease.

Case report: We report the case of a young patient who presented with a syndromic form of Moya-Moya angiopathy after cranial radiation therapy for an optic glioma associated with type 1 neurofibromatosis treated by combined revascularization. We discuss the particularities of syndromic forms, in their presentation and management based on a review of the literature.

Conclusion: Many diseases can be associated with Moya-Moya syndrome. Symptomatic patients should undergo surgery, but the risk of postoperative complications appears to be greater than that encountered in patients with non-syndromic Moya-Moya angiopathy.

Keywords: Cranial irradiation; Direct revascularisation; Moya-Moya syndrome; Neurofibromatosis; Temporo-cortical anastomosis.

Publication types

  • Case Reports
  • Review

MeSH terms

  • Cerebral Hemorrhage / diagnostic imaging
  • Cerebral Revascularization
  • Child, Preschool
  • Cranial Irradiation / adverse effects*
  • Female
  • Humans
  • Moyamoya Disease / diagnostic imaging
  • Moyamoya Disease / etiology
  • Moyamoya Disease / surgery*
  • Neurofibromatosis 1 / complications
  • Optic Nerve Glioma / etiology
  • Optic Nerve Glioma / radiotherapy*
  • Syndrome
  • Young Adult