Table 2:

Summary of reported cases of Moyamoya syndrome in association with Graves disease

StudyAge/Sex (y)RaceClinical PresentationsCerebral Angiographic FindingsOutcome
Kushima et al326/FJapaneseThyrotoxicosis, recurrent hemiparesis, speech disturbanceTypical netlike vessels at the base of brain, occlusion of right ACA and MCARecovery
Kushima et al322/FJapaneseThyrotoxicosis, hemiparesisNarrowing of bilateral ICA, netlike vessels at the base of brainRecovery
Liu et al428/FChineseThyrotoxicosis, hemiparesisBilateral ACA and MCA occlusion with Moyamoya vessels, tubular stenosis of bilateral cervical ICANot described
Tendler et al537/FHispanicThyrotoxicosis, hemiparesisRight distal ICA, proximal MCA, and ACA occlusion, collateral from PCARecovery
Tendler et al547/FCaucasianMoyamoya disease was diagnosed 10 years before thyrotoxicosisBilateral MCA occlusion, “puff of smoke” vessels on left basal gangliaRecovery
Leno et al621/MHispanicDown syndrome, hemiparesis, thyrotoxicosisMarked stenoses of both supraclinoid ICA, decreased flow over MCA, occluded ACA, prominent lenticulostratesRecovery
Kim et al737/FKoreanThyrotoxicosis, cardiomegaly, pulmonary edema, seizureBilateral ICA and left MCA occlusion (by MR angiography)Recovery
Nakamura et al 823/FJapaneseThyrotoxicosis, cardiomegaly, cerebral infarctionMultiple intracranial arterial stenoses, netlike collaterals around circle of WillisRecovery after revasculization
Nakamura et al854/FJapaneseUpper limits of normal range of thyroid function, hemiparesisMultiple intracranial arterial stenosis around circle of WillisRecovery after revasculization
Hsu et al (this study)40/FCaucasianThyrotoxicosis, rapid progressive bilateral cerebral infarctionBilateral distal ICA and proximal MCA and ACA occlusionDied
  • Note:—ACA indicates anterior cerebral artery; MCA, middle cerebral artery; ICA, internal carotid artery; PCA, posterior cerebral artery.