ABSTRACT
Moyamoya disease (MMD) is a rare, progressive cerebrovascular disorder
characterized by the narrowing of the internal carotid arteries, leading
to ischemic events. This case describes a 20-year-old male who presented
with left-sided weakness, slurred speech, and right-sided facial
deviation. His symptoms started with a right-sided headache and
progressed over several days. The patient had a significant history of
pulmonary valve stenosis but no history of substance abuse or other
vascular risk factors. Neurological examination showed left-sided motor
weakness and facial nerve involvement. Imaging studies, including MRI
and CT angiograms, revealed infarcts in the right frontoparietal and
temporal regions, along with significant narrowing of the internal
carotid arteries and the presence of collateral vessels, suggestive of
MMD disease. Serological tests ruled out other causes of vasculitis or
infectious etiologies. Following the diagnosis, the patient was managed
with aspirin, and his symptoms gradually improved. This case underscores
the importance of considering MMD disease in young patients presenting
with stroke-like symptoms and highlights the role of imaging in its
diagnosis.