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NEUROLOGY 2007;68:E21
© 2007 American Academy of Neurology
Resident and Fellow Section

Lenticulostriate-medullary artery anastomoses in moyamoya disease

Hyun-Ji Cho, MD, Dong Beom Song, MD, Hye-Yeon Choi, MD and Ji Hoe Heo, MD, PhD

From the Department of Neurology, Yonsei University College of Medicine, Seoul, Korea.

Address correspondence and reprint requests to Dr. Ji Hoe Heo, Department of Neurology, Yonsei University College of Medicine, 134 Shinchon-dong, Seodaemoon-gu, 120-752, Seoul, Korea; e-mail: jhheo{at}yumc.yonsei.ac.kr

The development of extensive collaterals is a characteristic feature of moyamoya disease. They include basal collaterals, which are composed of lenticulostriate and thalamoperforate arteries, leptomeningeal collaterals from the posterior cerebral arteries, and transdural collaterals from the external cerebral arteries.1 In a normal brain, the ends of the len-ticulostriate and medullary arteries of the middle cerebral artery are not connected. Although anastomoses between these two arteries may develop in moyamoya disease, typical angiographic findings are rarely reported.2 We present angiography findings (figure) in a 57-year-old woman with moyamoya disease who presented with intermittent weakness in her left arm and showed lenticulostriate-medullary artery anastomoses.


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  		Figure. Sequencing of the right carotid anteroposterior angiograms from initial (A) to early (B), mid (C), and late (D) arterial filling. It shows steno-occlusion of the anterior and middle cerebral arteries. Fine vascular networks (arrows) from the lenticulostriate arteries anastomose with medullary arteries, which eventually reconstitute the middle cerebral artery.

 

Footnotes

Supported by a grant from the Korea Health 21 Research and Development Project, Ministry of Health & Welfare, Republic of Korea (A060272).

Disclosure: The authors report no conflicts of interest.

Received September 21, 2006. Accepted in final form November 30, 2006.

References

  1. Lee JY, Kim KS, Song SK, Ahn SH, Nam HS, Heo JH. Atypical territorial infarction in moyamoya disease. Neurology 2005;65:E28.[Free Full Text]
  2. Takahashi M. Magnification angiography in moyamoya disease: new observations on collateral vessels. Radiology 1980;136:379–386.[Abstract/Free Full Text]




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