Bilateral Moyamoya disease resulting in anterior circulation stroke: first case report in Sri Lanka

Bilateral Moyamoya disease is a rare vascular cause of young onset ischaemic stroke, characterised by progressive narrowing of the cerebral vessels. We present a case of a 28-year-old Sri Lankan man with a unilateral headache presenting with sudden onset of expressive aphasia without face, arm or l...

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Main Authors: T. Tharsiga, S. Yathukulan, P. Mayurathan
Format: Article
Language:English
Published: Sri Lanka College of Internal Medicine 2025-08-01
Series:Asian Journal of Internal Medicine
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Online Access:https://account.ajim.sljol.info/index.php/sljo-j-ajim/article/view/261
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author T. Tharsiga
S. Yathukulan
P. Mayurathan
author_facet T. Tharsiga
S. Yathukulan
P. Mayurathan
author_sort T. Tharsiga
collection DOAJ
description Bilateral Moyamoya disease is a rare vascular cause of young onset ischaemic stroke, characterised by progressive narrowing of the cerebral vessels. We present a case of a 28-year-old Sri Lankan man with a unilateral headache presenting with sudden onset of expressive aphasia without face, arm or leg weakness. Magnetic resonance imaging revealed evidence of multiple infarctions involving both left and right middle cerebral territories. The diagnosis was made based on the magnetic resonance angiography, which demonstrated the absence of supra clinoid segments of bilateral middle cerebral arteries (MCA) and the presence of significant collateral formation which are typical of Moyamoya disease. He was commenced on low dose aspirin, high intensity statin and speech therapy. He had a favourable outcome. Although a genetic component is commonly associated with Moyamoya disease, no such family history was identified and immunological, infectious, haematological, vascular, or congenital syndromes were not found. This is the first case of bilateral Moyamoya disease reported from Sri Lanka.
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institution Kabale University
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publishDate 2025-08-01
publisher Sri Lanka College of Internal Medicine
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series Asian Journal of Internal Medicine
spelling doaj-art-1d89ffdc1e3b40fc800dbe775f26b4622025-08-20T04:01:23ZengSri Lanka College of Internal MedicineAsian Journal of Internal Medicine2827-72602025-08-014210.4038/ajim.v4i2.261Bilateral Moyamoya disease resulting in anterior circulation stroke: first case report in Sri LankaT. Tharsiga0S. Yathukulan1P. Mayurathan2Teaching Hospital BatticaloaTeaching Hospital BatticaloaTeaching Hospital Batticaloa Bilateral Moyamoya disease is a rare vascular cause of young onset ischaemic stroke, characterised by progressive narrowing of the cerebral vessels. We present a case of a 28-year-old Sri Lankan man with a unilateral headache presenting with sudden onset of expressive aphasia without face, arm or leg weakness. Magnetic resonance imaging revealed evidence of multiple infarctions involving both left and right middle cerebral territories. The diagnosis was made based on the magnetic resonance angiography, which demonstrated the absence of supra clinoid segments of bilateral middle cerebral arteries (MCA) and the presence of significant collateral formation which are typical of Moyamoya disease. He was commenced on low dose aspirin, high intensity statin and speech therapy. He had a favourable outcome. Although a genetic component is commonly associated with Moyamoya disease, no such family history was identified and immunological, infectious, haematological, vascular, or congenital syndromes were not found. This is the first case of bilateral Moyamoya disease reported from Sri Lanka. https://account.ajim.sljol.info/index.php/sljo-j-ajim/article/view/261Moyamoya diseaseIschaemic stroke
spellingShingle T. Tharsiga
S. Yathukulan
P. Mayurathan
Bilateral Moyamoya disease resulting in anterior circulation stroke: first case report in Sri Lanka
Asian Journal of Internal Medicine
Moyamoya disease
Ischaemic stroke
title Bilateral Moyamoya disease resulting in anterior circulation stroke: first case report in Sri Lanka
title_full Bilateral Moyamoya disease resulting in anterior circulation stroke: first case report in Sri Lanka
title_fullStr Bilateral Moyamoya disease resulting in anterior circulation stroke: first case report in Sri Lanka
title_full_unstemmed Bilateral Moyamoya disease resulting in anterior circulation stroke: first case report in Sri Lanka
title_short Bilateral Moyamoya disease resulting in anterior circulation stroke: first case report in Sri Lanka
title_sort bilateral moyamoya disease resulting in anterior circulation stroke first case report in sri lanka
topic Moyamoya disease
Ischaemic stroke
url https://account.ajim.sljol.info/index.php/sljo-j-ajim/article/view/261
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AT syathukulan bilateralmoyamoyadiseaseresultinginanteriorcirculationstrokefirstcasereportinsrilanka
AT pmayurathan bilateralmoyamoyadiseaseresultinginanteriorcirculationstrokefirstcasereportinsrilanka