We report a case of moyamoya disease in a young adult female, in whom the initial clinical and radiological features were considered to be compatible with multiple sclerosis. Magnetic resonance imaging (MRI) features of dilated collateral arteries were then recognized, and the initial MRI findings considered to represent demyelination were reinterpreted as areas of infarction. Although rare, moyamoya disease should be considered in the differential diagnosis in young patients presenting with symptoms and signs suggestive of multiple sclerosis. The diagnosis may be suggested by typical MRI findings.
Again, same MRI demyelination we see in stroke, cerebrovascular disease, and CCSVI. In this instance, it's slowed blood flow going into the brain, and opening the affected intracerebral arteries brings relief.
We believe that moyamoya disease should be considered in multiple sclerosis variants who present with paresthesias and do not respond to traditional immunosuppressive therapies.
Early diagnosis and revascularization procedures could help prevent further neurologic sequelae. Furthermore, subtle MRI findings should suggest obtaining a CTA/MRA or a formal angiogram to identify moyamoya vessels
thanks for linking the study over here, Cece. I find it less annoying (for myself) and less confusing to readers to write on Facebook, and appreciate you dealing with TIMS....