A case of acute confusional state in a patient of chronic hemolytic anemia with secondary Moya–Moya disease

Abstract

Acute confusional state is characterized by disturbed consciousness, cognitive function, or perception. It can develop over a period of hours to days. It can be because of intracranial hemorrhage, central venous sinus thrombosis, stroke, meningoencephalitis, metabolic abnormalities, adverse drug reactions, etc. Moya–moya disease is a rare, progressive cerebrovascular disorder caused by blocked arteries at the base of the brain in the basal ganglia and means “puff of smoke” appearance which describes the look of the tangled vessels. It can present as stroke or recurrent transient ischaemic attacks. Secondary moya–moya disease can be caused by infections, connective tissue disorders, vasculitis, autoimmune disorders, trauma, hematological conditions, atherosclerosis, etc. Here, we present a case of 14-year-old female, known case of Beta Thalassemia who presented with acute confusional state, incidentally diagnosed with secondary moya–moya and tuberculous meningitis. Acute confusional state here was attributed to tuberculous meningitis.