Asymmetric lenticulostriate arteries in patients with moyamoya disease presenting with movement disorder: three new cases

Abstract

Objective: Unilateral movement disorder associated with moyamoya disease is a rare finding and the mechanism remains to be fully elucidated. Theories postulated include contralateral cerebral ischemic or hemorrhagic lesions, and/or hypoperfusion. However, few studies have reported such patients without contralateral lesions nor hypoperfusion. This study aimed to explore the potential mechanism of those who had neither contralateral cerebral lesions nor hypoperfusion.

Methods: Neuroradiological features of lenticulostriate arteries in three cases with unilateral movement disorder associated with moyamoya disease who had neither contralateral lesions nor hypoperfusion were mainly analyzed.

Results: Angiography and 3 T black-blood T1-weighted intracranial vessel wall imaging both demonstrated a significant asymmetry between bilateral lenticulostriate arteries qualitatively and quantitatively on admission. After one-year follow-up, two patients' vessel wall imaging indicated that the asymmetry diminished, and the symptoms spontaneously resolved.

Conclusion: This report demonstrated that patients with moyamoya disease with unilateral movement disorder who had neither contralateral lesions nor hypoperfusion may be related to the asymmetry between bilateral lenticulostriate arteries through basal ganglia.

Keywords: Moyamoya disease; lenticulostriate artery; magnetic resonance imaging; movement disorder; vessel wall imaging.