Od akutne psihoze do Moyamoya sindroma

Abstract

Moyamoya disease is a rare idiopathic cerebral vasculopathy that is characterized by stenosis or occlusion of major cerebral arteries, most often within the circle of Willis, which leads to the proliferation of the of small collateral vessels. Moyamoya can develop in association with numerous other diseases and conditions, some of which are autoimmune diseases, and is inclusively named 'moyamoya syndrome.' Angiography is not only the most effective means of diagnosing, but also in monitoring the patient with Moyamoya disease. Case Presentation: We described the case of a 22-year old female patient with type 1 diabetes, Hashimoto thyroiditis, and dyslipidemia, who has been admitted to a psychiatric institution due to symptoms of anxiety, worry, irritability, affective lability, and aggressive episodes. Moving along the course of the case, the manifestation of disorientation, lack of communication, and significant cognitive impairment memory and attention impairments) alongside mental inflexibility, the lack of impulse control, and emotional incontinence were all observed symptoms. A MSCT angiography of intracranial blood vessels was performed, where the findings correspond to significant stenosis of both ACIs. An antiplatelet therapy approach was advised, with a high dose of statin and intensive insulin therapy. Conclusion: We highlight the importance of recognizing moyamoya syndrome in younger patients with T1D who have newly diagnosed psychiatric diseases (or symptoms or signs) and premature cognitive decline with neurologic symptomatology, as prompt diagnosis and treatment can have major impact on patient outcome and quality of life.