Hyperthyroidism Combined With Moyamoya Disease. Report Of Two Cases And Review Of The Literature

Objective:To explore the pathogenesis, clinical features and treatment strategies of hyperthyroidism combined with moyamoya disease.Methods:In this study, two cases of hyperthyroidism combined with moyamoya disease were described. At the meantime, we review the literature by searching the database of Chinenes scientific and technical journals,CBM,CNK,Pubmed from 1991 until now.Results:Coexistence of moyamoya disease and hyperthyroidism is very rare. Onset of hyperthyroidism is prior to moyamoya disease.50 cases are found in the literatures,in these cases:The incidence of women is higher than men and is more ofen seen in young and middle-aged women. The incidence of Asia is higher than European and American countries, and the disease is combined with familial and genetic factors. 90% of the patients are onset of ischemic cerebrovascular disease,and most of the patients are in the thyrtoxic state. Most of cerebral imaging exzamination shows cerebral infarcion and bilateral lesions are more often seen in the cerebral angiograms, only few of them shows net-like vessles. Some patients combined with other disease such as down syndrome and diabetes. Anti-thyroid therapy and neurogic treatment is effective and revascularization surgery is may improve long-term outcomes and prevent recurrence.Conclusions:Hyperthyroidism is a risk factor of moyamoya disease. There is a possible pathogenic link between hyperthyroidism and moyamoya disease. High level of thyroxine may induce ischemic cerebrovascular disease, then control the thyroid symptoms will reduce the cerebrovascular accidents. In addition, the young person who sufferd stroke with no risk factors of cerebrovascular disease should take thyroid function exzamination and cerebral MRA or DSA to early diagnosis and tretment.