Case Report
Copyright ©The Author(s) 2022. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Clin Cases. May 16, 2022; 10(14): 4617-4624
Published online May 16, 2022. doi: 10.12998/wjcc.v10.i14.4617
Acute recurrent cerebral infarction caused by moyamoya disease complicated with adenomyosis: A case report
Shao Zhang, Li-Ming Zhao, Bing-Qian Xue, Hao Liang, Gao-Chao Guo, Yang Liu, Rui-Yu Wu, Chao-Yue Li
Shao Zhang, Bing-Qian Xue, Hao Liang, Rui-Yu Wu, Chao-Yue Li, Department of Neurosurgery, Henan University People's Hospital, Henan Provincial People's Hospital, Zhengzhou 450000, Henan Province, China
Li-Ming Zhao, Gao-Chao Guo, Yang Liu, Department of Neurosurgery, Zhengzhou University People's Hospital, Henan Provincial People's Hospital, Zhengzhou 450000, Henan Province, China
Author contributions: Xue BQ and Wu RY collected clinical medical records of patients; Liu Y and Guo GC collected the gynecological pathological data of the patients; Zhao LM and Liang H collected relevant imaging data; Zhang S and Li CY wrote the paper; All authors have given final approval to the version to be submitted.
Informed consent statement: Participants in this study had provided written informed consent prior to study registration.
Conflict-of-interest statement: The authors declare having no conflicts of interest.
CARE Checklist (2016) statement: The authors have read the CARE Checklist (2016), and the manuscript was prepared and revised according to the CARE Checklist (2016).
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Chao-Yue Li, MD, Professor, Department of Neurosurgery, Henan University People's Hospital, Henan Provincial People's Hospital, No. 8 Weiwu Road, Jinshui District, Zhengzhou 450000, Henan Province, China. lichaoyue1973@aliyun.com
Received: October 20, 2021
Peer-review started: October 20, 2021
First decision: February 14, 2022
Revised: February 23, 2022
Accepted: March 16, 2022
Article in press: March 16, 2022
Published online: May 16, 2022
Processing time: 204 Days and 17.7 Hours
Abstract
BACKGROUND

Moyamoya disease is essentially an ischemic cerebrovascular disease. Here, we describe a case of acute recurrent cerebral infarction caused by moyamoya disease with concurrent adenomyosis which, to our knowledge, is the first in the literature. A literature review is also presented.

CASE SUMMARY

A 38-year-old female presented to the Research and Treatment Center of Moyamoya Disease in our hospital with "left limb weakness" as the main symptom. She was diagnosed with acute cerebral infarction and moyamoya disease through magnetic resonance imaging and digital subtraction angiography. Prior to this, she had experienced a prolonged menstrual period of one-month duration. This was investigated and adenomyosis was diagnosed. After passing the acute cerebral infarction phase, the patient underwent surgery for adenomyosis followed by combined cerebral revascularization. During the postoperative follow-up, improvements of the perfusion imaging stage and modified Rankin Scale were observed. A review of the literature showed only 16 reported cases of gynecological diseases complicated with stroke. The clinical characteristics, pathogenesis, therapeutic effects, and long-term prognosis of these cases have been studied and discussed.

CONCLUSION

In patients with moyamoya disease, early management of gynecological-related bleeding disorders is essential to prevent the complications of cerebral events.

Keywords: Moyamoya disease; Combined cerebral revascularization; Acute recurrent cerebral infarction; Abnormal uterine bleeding; Adenomyosis; Case report

Core Tip: For women with moyamoya disease, several factors may contribute further to the increased risk of stroke. Based on our report, abnormal uterine bleeding caused by gynecological diseases is a rare risk factor. In the literature to date, there is no case study on acute recurrent cerebral infarction caused by moyamoya disease combined with adenomyosis. Our case report represented the first, with detailed description of the sequence, safety, and long-term outcomes of the treatment.