Rebleeding from de novo aneurysm arising on a small artery which bifurcated from the recipient middle cerebral artery, after revascularization surgery in an adult moyamoya disease patient with hemorrhagic onset: A case report

Abstract

In adult patients with hemorrhagic moyamoya disease, in order to reduce hemodynamic stress on the fragile moyamoya vessels, direct or indirect revascularization is often performed. In Japan, its effectiveness is being examined in the Japan Adult Moyamoya Trial (JAMT). We report here a rare case of rebleeding from de novo aneurysm at an atypical location, at 4 years after revascularization surgery in a hemorrhagic moyamoya disease patient. Neuroendoscope surgery followed by endovascular surgery was very effective in this case.