• World Neurosurg · Apr 2016

    Case Reports

    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.

    • Satoru Tanioka, Masato Shiba, Yasuyuki Umeda, Takanori Sano, Masayuki Maeda, and Hidenori Suzuki.
    • Department of Neurosurgery, Mie University Graduate School of Medicine, Tsu, Japan. Electronic address: satoru-tanioka@umin.net.
    • World Neurosurg. 2016 Apr 1; 88: 688.e17-688.e21.

    BackgroundMoyamoya disease often is treated by revascularization surgery. In this report, we are the first to describe a case of moyamoya disease that repeatedly showed a transient subcortical low intensity (SCLI) on fluid-attenuated inversion recovery (FLAIR) magnetic resonance images postoperatively.Case DescriptionA 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 neurologic deterioration. Findings on magnetic resonance imaging were not particular apart from SCLI and sulcal hyperintensity on FLAIR images, but no abnormalities in cerebral blood flow on single-photon emission computed tomography with N-isopropyl [123I]-p-iodoamphetamine 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.ConclusionsThe mechanisms of transient SCLI on FLAIR images remain unclear, but this finding appears to be associated with a postoperative transient neurologic deterioration.Copyright © 2016 Elsevier Inc. All rights reserved.

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