CASE REPORT Rapidly Progressive Fatal Bihemispheric Infarction Secondary to Moyamoya Syndrome in Association with

SUMMARY: Moyamoya syndrome is the secondary form of intracranial arterial occlusive diseases that produces collateral vessels from the base of brain. We report a case of Moyamoya syndrome developing in association with Graves thyrotoxicosis; as a result of its rapid progression and severe global ischemia, it was ultimately fatal. Because of the rarity of this association, we reviewed the literature in an attempt to establish possible demographic and clinical characteristics that may suggest putative mechanisms of pathogenesis. We report a case of Graves disease with thyroid stormassociated with Moyamoya syndrome, which is partic-ularly noteworthy because of a very rapid progression of the cerebrovascular occlusive disease thatwas ultimately fatal. The unusual aggressive nature of our case prompted us to review the literature in an attempt to establish possible demographic, clinical, and laboratory patterns that may help to eventually elucidate putative mechanisms of pathogenesis. Case Report A 40-year-old woman with a 6-month history of Graves disease un