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.