Posted by Sailpappy (12.77.153.137) on June 24, 2001 at 10:42:40:
Moyamoya disease is an idiopathic, noninflammatory vasculopathy confined to
the intracranial arteries and primarily involving the major branches of the
internal carotid artery. The hallmark of the disease is a mesh of fine vessels
at the base of the brain, which appears like a "puff of smoke". and serves as collaterals
as the major intracranial vessels occlude. It is most commonly detected in Japan. It is most
frequent in children, adolescents, and young adults, and causes ischemic stroke,
TIA or intracranial bleeding. Arteriography (Dye injected into the brain) is
required for diagnosis. The prognosis of patients with moyamoya is guarded,
progressive neurologic worsening and recurrent events are the rule. Patients are
often prescribed anti platlet aggregating drugs or warfarin but their is
little proof that these drug work. Surgical procedures including bypass operations
and transposition of muscle or omentum to the surface of the brain have been
recommended. Migraine treatment for this disorder is controversial but in general
narcotics should be avoided. Tricyclics and seratonin reuptake inhibitors can be considered.
If she has not tried calcium channel blockers then that can also be discussed
with her doctor. In general we would recommend that she be followed by a stroke
neuologist who has had experience with this disorder. Our stroke neurologists at the Cleveland
Clinic have experience with this disorder and if a consultation was wanted
you could call 216 444 5559 to schedule. Good luck. This information is given
for general medical information purposes only. Please consult your doctor to discuss
diagnostic or treatment interventions.