Headache Associated with Moyamoya Disease in a Child: Pain Pattern in MRA Progression.

Lee,  Woo Jin; Kim,  Young Ok; Yoon,  Woong; Rho,  Young Il; Woo,  Young Jong

doi:2014.22.2.98

Ann Child Neurol > Volume 22(2); 2014 > Article

Case Report

Journal of the Korean Child Neurology Society 2014;22(2):98-101.
DOI: https://doi.org/10.26815/jkcns.2014.22.2.98 Published online June 30, 2014.

Headache Associated with Moyamoya Disease in a Child: Pain Pattern in MRA Progression.

Woo Jin Lee, Young Ok Kim, Woong Yoon, Young Il Rho, Young Jong Woo

¹Department of Pediatrics, Chonnam National University Medical School, Gwangju, Republic of Korea. ik052@jnu.ac.kr
²Department of Radiology, Chonnam National University Medical School, Gwangju, Republic of Korea.
³Department of Pediatrics, School of Medicine, Chosun University, Gwangju, Republic of Korea.

Abstract

Headache associated with moyamoya disease (HAMD) has been reported in about 20-30% of pediatric cases with moyamoya disease. However, the characteristic patterns of HAMD during disease progression are not completely known, although much is known on the incidence of HAMD and on the treatment effects of bypass surgery. In a child who presented with HAMD and had no infarction or hemorrhage till bypass surgery, we described the characteristic patterns of headache progression. At first presentation, the patient complained of severe bilateral headache despite mild stenosis only in the left internal carotid artery on brain magnetic resonance angiography. During all stages of progression, headache was severe and pressing in nature rather than throbbing. Nausea and vomiting were present even in the early stage, but photophobia, phonophobia and neck stiffness developed in the late stage. Headache was aggravated by menstruation and was relieved by analgesics and topiramate in the early stage, although the medication failed to provide relief when the headache increased in frequency and duration.

Key Words: Moyamoya disease, Headache, Child