2018 Volume 23 Issue 1 Pages 54-58
We herein report a 13‒year‒old female patient who presented with moyamoya disease (MMD) with intracerebral hemorrhage (ICH). This pediatric patient was transferred to our emergency center with a sudden headache and general seizure. On admission, her Glasgow Coma Scale (GCS) score was 6 (E1V1M4) with anisocoria. Cranial computed tomography (CT) showed ICH in the right frontal lobe with intraventricular hemorrhaging. A CT angiogram revealed a steno‒occlusive state in the bilateral anterior and middle cerebral arteries, indicating MMD. Immediately after CT angiography, we performed neuroendoscopic surgery to rapidly remove the intracerebral and intraventricular hematoma and to preserve the superficial temporal artery for subsequent bypass surgery. On both the 38th and 58th days, we performed bilateral encephalo‒dura‒arterio‒synangiosis. Her GCS score improved from 6 to 15 and her modified ranking scale score improved from 5 to 3. No rebleeding or ischemic symptoms occurred thereafter. Neuroendoscopic surgery may therefore be useful for the treatment of pediatric MMD presenting with ICH.
