Case Report
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World J Clin Cases. Sep 16, 2014; 2(9): 474-477
Published online Sep 16, 2014. doi: 10.12998/wjcc.v2.i9.474
Champagne bottle neck sign in a patient with Moyamoya syndrome
Takafumi Shimogawa, Takato Morioka, Tetsuro Sayama, Takeshi Hamamura, Chiharu Yasuda, Shuji Arakawa
Takafumi Shimogawa, Takato Morioka, Tetsuro Sayama, Takeshi Hamamura, Department of Neurosurgery, Kyushu Rosai Hospital, Fukuoka 800-0296, Japan
Chiharu Yasuda, Shuji Arakawa, Department of Cerebrovascular Disease, Kyushu Rosai Hospital, Fukuoka 800-0296, Japan
Author contributions: All authors contributed to this work
Correspondence to: Takafumi Shimogawa, MD, Department of Neurosurgery, Kyushu Rosai Hospital, 1-1 Sonekitamachi, Kokura Minami-Ku, Kitakyushu, Fukuoka 800-0296, Japan. shimogawa28@gmail.com
Telephone: +81-93-4711121 Fax: +81-93-4730627
Received: January 12, 2014
Revised: June 24, 2014
Accepted: July 15, 2014
Published online: September 16, 2014
Processing time: 256 Days and 3.1 Hours
Abstract

The champagne bottle neck (CBN) sign refers to a reduction in the diameter of the proximal portion of the internal carotid artery that resembles a CBN, and is a characteristic feature of Moyamoya disease. A 43-year-old woman with an infarction of the posterior limb of the left internal capsule was diagnosed with Moyamoya syndrome associated with Graves’ disease. The CBN sign was observed bilaterally. Cerebral revascularization surgery was performed, including left-sided superficial temporal artery to middle cerebral artery anastomosis. During four years of follow-up, she maintained a euthyroid state and did not have any further cerebral ischemic events. The CBN signs remained unchanged on both sides during this time. This is the first report of the CBN sign in a patient with Moyamoya syndrome associated with Graves’ disease.

Keywords: Champagne bottle neck sign; Moyamoya disease; Moyamoya syndrome; Graves’ disease; Revascularization

Core tip: The champagne bottle neck (CBN) sign reflects a reduction in the diameter of the proximal portion of the internal carotid artery that resembles a CBN, and is a characteristic feature of Moyamoya disease. This case describes the first report of bilateral CBN signs in a 43-year-old woman diagnosed with Moyamoya syndrome associated with Graves’ disease. Cerebral revascularization surgery was performed on the patient, and the CBN signs remained unchanged throughout four years of follow-up.