Unilateral hemorrhagic moyamoya disease and contralateral cavernous aneurysm in an Indian woman treated with stent-assisted coil technique: case report

Abstract Background Moyamoya disease (MMD) is a chronic, progressive occlusion of the arteries around the circle of Willis that leads to the development of characteristic collateral vessels seen on cerebral angiography. MMD is commonly accompanied by intracranial aneurysms; however, the current literature is sparse regarding the best available treatment options for aneurysms in patients with MMD. Long-term angiographic outcome is also not well established. Case description We report the safety and efficacy of stent-assisted coiling in an adult Indian woman of unilateral hemorrhagic MMD having a large asymptomatic cavernous segment aneurysm on the contralateral side. The patient had excellent angiographic occlusion without any recurrence/hemorrhage in the 5-year follow-up after the procedure. Conclusion MMD should be kept in mind in evaluating patients presenting with cerebrovascular accidents. The case strengthens the view that stent-assisted coil embolization of large saccular aneurysms around the circle of Willis is a viable minimally invasive therapeutic option in such unusual patients