Abstract
Background: Moyamoya disease is a progressive occlusive cerebrovascular disorder most prevalent in Asia. It results in neovascularization that can lead to hemorrhagic stroke. Pregnancy physiologic changes can further exacerbate the risk of fatal hemorrhagic stroke. Case: We present the case of a 31 year-old woman gravida 2 para 1 presenting to the emergency department with neurologic symptoms. She carried a diagnosis of Moyamoya disease and had multiple cerebrovascular accidents. She was found to be pregnant in the third trimester. Concerns regarding the patient’s care and treatment plan are outlined and addressed in this case report. Conclusion: The care of a patient with a rare medical condition requires a multidisciplinary care plan with members of the team directly and closely involved in the patient’s care.
Highlights
Moyamoya disease (MMD) is a rare and potentially devastating stenoocclusive disorder
In order to optimize the care of a patient with a high risk of mortality in pregnancy, an organized, tightly aligned, hands on multidisciplinary team with clear communication is necessary
MMD primarily results from progressive stenosis of the distal portions of the internal carotid artery (ICA) resulting in development of collaterals originating from the lenticulostriate arteries at the base of the brain [1]
Summary
In order to optimize the care of a patient with a high risk of mortality in pregnancy, an organized, tightly aligned, hands on multidisciplinary team with clear communication is necessary
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