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Moyamoya hyperthyroid

Jun Hyong Ahn, Jin Pyeong Jeon, Jeong Eun Kim, Eun Jin Ha, Won-Sang Cho, Young Joo Park, Nam Han Cho, Hoon Sung Choi, Hyun-Seung Kang, Young-Je Son, Jae Seung Bang, Chang Wan Oh
The aim of this study was to investigate the specific thyroid condition and thyroid autoantibodies in adult moyamoya disease (MMD) according to clinical presentation (ischemia vs. hemorrhage stroke). In addition, a meta-analysis was performed to reveal the association between adult MMD and elevated thyroid function, or autoantibodies. Prospectively collected data on 169 consecutive patients with MMD at a single institution were analyzed. Community-based controls matched for age and sex were selected for comparison...
March 15, 2018: Neurologia Medico-chirurgica
Julian Choi, Perin Suthakar, Farbod Farmand
We describe the case of a young Hispanic female who presented with thyrotoxicosis with seizures and ischemic stroke. She was diagnosed with a rare vasculopathy - moyamoya syndrome. After starting antithyroid therapy, her neurologic symptoms did not improve. Acute neurosurgical intervention had relieved her symptoms in the immediate post-operative period after re-anastomosis surgery. However, 2 post-operative days later, she was found to be in status epilepticus and in hyperthyroid state. She quickly deteriorated clinically and had expired a few days afterward...
2016: Endocrinology, Diabetes & Metabolism Case Reports
Shinnosuke Shiono, Chiho Ota, Tatsuyuki Imada, Yukio Hayashi, Yuji Fujino
Quasi-moyamoya disease defined as moyamoya disease combined with autoimmune diseases such as Graves' disease is rare. We report anesthetic management of a patient with quasi-moyamoya disease undergoing total thyroidectomy for Graves' disease resistant to medical therapy. This disease is characterized by the aggravation of cerebral ischemic symptoms with hyperthyroidism. We, therefore, applied steroid pulse therapy before the operation to induce temporal normalization of the thyroid function, and could perform safe anesthetic management of this patient with quasi-moyamoya disease...
July 2015: Masui. the Japanese Journal of Anesthesiology
Byoungho H Noh, Sang-Won Cho, Sung Yeon Ahn
Diabetic ketoacidosis (DKA) is one of the precipitating factors that can evoke a thyroid storm. Thyroid storm may cause cerebral ischemia in Moyamoya disease, which can coexist in patients with Graves' disease. A 16-year-old girl complaining of dizziness and palpitations visited the emergency department and was diagnosed with DKA combined with hyperthyroidism. A thyroid storm occurred 6 h after the start of DKA management. Her Burch and Wartofsky score was 65 points. Right hemiplegia developed during the thyroid storm, and brain magnetic resonance (MR) diffusion-weighted images revealed multiple acute infarcts in both hemispheres...
February 2016: Journal of Pediatric Endocrinology & Metabolism: JPEM
Satoru Miyawaki, Hideaki Imai, Masahiro Shimizu, Shinichi Yagi, Hideaki Ono, Hirofumi Nakatomi, Tsuneo Shimizu, Nobuhito Saito
BACKGROUND: Quasi-moyamoya disease (MMD) and MMD (definite MMD) have similar cerebral angiographic features, but whether these related diseases have similar etiology or genetic background remains unclear. Recently, we have reported that the recently identified MMD susceptibility gene variant RNF213 c.14576G>A (rs112735431) was associated with atherosclerotic intracranial major artery stenosis/occlusion. The present study investigated the occurrence of RNF213 c.14576G>A in patients with nonatherosclerotic quasi-MMD...
May 2015: Journal of Stroke and Cerebrovascular Diseases: the Official Journal of National Stroke Association
C Lei, B Wu, Z Ma, S Zhang, M Liu
BACKGROUND AND PURPOSE: Evidence suggests that elevated thyroid function and elevated levels of thyroid autoantibodies are associated with risk of moyamoya disease (MMD). Therefore a meta-analysis of all available evidence was performed, including unpublished data from our own center, in order to assess this association. METHODS: Major literature databases were reviewed without language restrictions to identify studies examining the association between MMD and thyroid function or thyroid autoantibodies...
July 2014: European Journal of Neurology: the Official Journal of the European Federation of Neurological Societies
Fumihiro Matano, Yasuo Murai, Koji Adachi, Takayuki Kitamura, Akira Teramoto
Cases of moyamoya disease or intracranial arterial stenosis around the circle of Willis (M/IAS) associated with hyperthyroidism have been reported. However, most of these previous reports were of the ischemic form of M/IAS and primary hyperthyroidism. To the best of our knowledge, no studies have documented therapy for M/IAS associated with hyperthyroidism. We discuss four previously unreported cases, including those involving the intracerebral hemorrhage form and thyroid-stimulating hormone (TSH) secretion from a pituitary adenoma (secondary hyperthyroidism)...
April 2014: Neurosurgical Review
Zhenghao Shi, Xuting Zhang, Zhicai Chen, David S Liebeskind, Min Lou
BACKGROUND: Previous studies have shown that hyperthyroidism was related to Moyamoya disease and intracranial artery stenosis. However, it is not clear whether thyroid hormone or thyroid autoantibodies was associated with them. AIMS AND/OR HYPOTHESIS: Thyroid autoimmunity was previously shown to be associated with Moyamoya disease. Our study aimed to investigate the association between thyroid autoantibodies and intracranial large artery stenosis in young ischemic stroke patients with apparent euthyroid states...
August 2014: International Journal of Stroke: Official Journal of the International Stroke Society
Desheng Li, Weizhong Yang, Peng Xian, Peng Liu, Xiangyang Bao, Rui Zong, Lian Duan
OBJECTIVE: To investigate the clinical features, pathogenesis and treatment effect of patients who had moyamoya disease (MMD) concurrent with Graves' disease (GD). PATIENTS AND METHODS: Retrospective analysis of the examination and treatment results of the MMD patients with GD from January 2003 to April 2012 treated by our teamwork. RESULTS: There were 1493 MMD patients included in this retrospective study. Among them, there were 16 female and 5 male MMD patients coexisted with Graves' diseases, and 15 of them were adult patients...
September 2013: Clinical Neurology and Neurosurgery
Kyu-Chang Wang, Ji Hoon Phi, Ji Yeoun Lee, Seung-Ki Kim, Byung-Kyu Cho
Moyamoya disease (MMD) is the most common pediatric cerebrovascular disease in Far Eastern countries. In children, MMD frequently manifests as ischemic symptomatology. Cerebral perfusion gradually decreases as the disease progresses, which often leads to cerebral infarction. The benefits of revascularization surgery, whether direct or indirect, have been well established in MMD patients with ischemic symptoms. In adults, the increase in cerebral blood flow achieved with indirect revascularization is often unsatisfactory, and direct revascularization is usually feasible...
November 2012: Korean Journal of Pediatrics
Shigeo Ohba, Toru Nakagawa, Hideki Murakami
Several studies have shown the relation between Graves' disease and stenosis/occlusion of intracranial arteries. To our knowledge, only 31 cases, including our case, of concurrent Graves' disease and moyamoya syndrome or intracranial arterial stenosis/occlusion have been described. The patients were predominantly women, and their ages ranged from 10 to 54 years (mean, 29.3 years). Transient ischemic attacks and cerebral infarction were the common symptoms in these patients. Except one previous case and the present case, all cases showed thyrotoxicity when the cerebral ischemic event occurred...
July 2011: Neurosurgical Review
Hao Li, Zheng-Shan Zhang, Zhen-Nan Dong, Mai-Juan Ma, Wei-Zhong Yang, Cong Han, Ming-Mei Du, Yun-Xi Liu, Hong Yang, Wei Liu, Lian Duan, Wu-Chun Cao
BACKGROUND AND PURPOSE: The purpose of this study was to investigate whether thyroid function and thyroid autoantibodies were associated with the risk of moyamoya disease in pediatric subjects. METHODS: Thyroid function and thyroid autoantibodies were evaluated in patients with moyamoya disease and control subjects, and their associations with moyamoya disease were estimated using multivariate analysis. RESULTS: We included 114 pediatric patients and 114 healthy control subjects...
April 2011: Stroke; a Journal of Cerebral Circulation
Ran Lee, Kihye Sung, Yong Mean Park, Jeong Jin Yu, Young-Cho Koh, Sochung Chung
Moyamoya disease is a cerebrovascular disorder of unknown cause, characterized by slowly progressive bilateral stenosis or occlusion of the internal carotid arteries and produces collateral vessels. Moyamoya syndrome has rarely been reported in association with Graves' disease, especially in children. Several reports suggest that a cerebral infarction might have occurred in patients with clinical and laboratory evidence of hyperthyroid function. We report a case of Moyamoya disease in a girl with Down syndrome and thyrotoxicosis, and we review the relevant literature...
August 31, 2009: Yonsei Medical Journal
Jun Ni, Shan Gao, Li-ying Cui, Shun-wei Li
OBJECTIVE: To investigate the distribution and clinical manifestations of intracranial arterial occlusive lesions (IAOLs), and their correlation with thyroid function. METHODS: We enrolled 7 patients who had Graves' disease (GD) with IAOLs screened and evidenced by transcranial Doppler, then further confirmed with digital substract angiography in 2 patients and magnetic resonance angiography in 5 patients. Brain magnetic resonance imaging (MRI) was performed in all 7 patients...
September 2006: Chinese Medical Sciences Journal, Chung-kuo i Hsüeh K'o Hsüeh Tsa Chih
A Squizzato, V E A Gerdes, D P M Brandjes, H R Büller, J Stam
BACKGROUND AND PURPOSE: Acute cerebral ischemia has been described in different diseases of the thyroid gland, and not only as a result of thyrotoxic atrial fibrillation and cardioembolic stroke. The purpose of this review is to summarize the studies on the relationship between thyroid diseases and cerebrovascular diseases, discussing the main findings for overt hyperthyroidism and hypothyroidism, as well as for subclinical thyroid dysfunction. SUMMARY OF REVIEW: In overt hyperthyroidism, cardioembolic stroke is clearly associated to thyrotoxic atrial fibrillation, and in subclinical hyperthyroidism with serum thyroid-stimulating hormone levels <0...
October 2005: Stroke; a Journal of Cerebral Circulation
Kazuhiro Nakamura, Kiyoyuki Yanaka, Satoshi Ihara, Tadao Nose
OBJECTIVE AND IMPORTANCE: The association of Graves' disease with multiple intracranial arterial stenoses is rare. CLINICAL PRESENTATION: We report on two Japanese women who experienced the concurrence of Graves' disease and cerebral ischemia attributable to multiple intracranial arterial stenoses around the circle of Willis. Clinically, these patients demonstrated hyperthyroidism, goiter, ophthalmopathy, and ensuing ischemic strokes. Cerebral angiography demonstrated multiple intracranial arterial stenoses around the circle of Willis in both cases...
November 2003: Neurosurgery
H Wakamoto, N Ishiyama, H Miyazaki, A Shinoda, H Tomita
We reported the case of a 19-year-old female complicated with Basedow disease. She was admitted, complaining of headache and endocrine function tests showed hyperthyroidism. CT scan revealed left intraventricle hemorrhage and angiography revealed the stenoses at the terminal portion of the bilateral internal carotid arteries (ICA) without basal moyamoya vessels. During the angiography, a thyroid crisis occurred and we initiated the antithyroid therapy. Bilateral CAG a month after the onset revealed that the stenoses had improved partially and the stenosis was thought to be vasospasm caused by the intraventricle hemorrhage...
April 2000: No Shinkei Geka. Neurological Surgery
B E Tendler, K Shoukri, C Malchoff, D MacGillivray, R Duckrow, T Talmadge, G R Ramsby
We describe two Caucasian women with the concurrence of Graves' disease and the moyamoya phenomenon (radiological evidence of collateral cerebral blood vessels like "puffs of smoke" due to cerebrovascular occlusive disease). One patient presented with acute cerebrovascular ischemia due to Moyamoya disease shortly after radioactive iodine therapy for Graves' disease and the second presented with Graves' disease 10 years after being diagnosed with moyamoya dysplastic cerebral vessels. The optimal treatment of hyperthyroidism in these patients is unknown; however, careful control of the hyperthyroidism by any modality seems reasonable...
August 1997: Thyroid: Official Journal of the American Thyroid Association
J S Liu, S H Juo, W H Chen, Y Y Chang, S S Chen
A 28-year-old woman presented with a clinical picture of hyperthyroidism, goiter, ophthalmopathy, and an ensuing ischemic stroke. Cerebral angiography demonstrated moyamoya vessels around the Willis's circle and tubular stenosis of the bilateral extracranial internal carotid arteries. The combination of the above angiographic abnormalities occurring in a patient with Graves' disease is extremely rare. A pathogenic link between Graves' disease and certain specific vascular disorders is suspected.
September 1994: Journal of the Formosan Medical Association, Taiwan Yi Zhi
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