Moyamoya disease associated with renovascular disease in a young African-Brazilian patient

Moyamoya is a rare disease characterized by fibrous dysplasia of the intern al carotid and proximal cerebral arteries, which has been described mainly in young Japanese. We present a case of Moyamoya disease with renal artery involvement in a young male patient with an African origin. A 15-year-old b oy was referred to our hospital due to uncontrolled blood pressure, headach e, somnolence, cognitive deficit and multiple lacunar infarcts in the compu ted tomography. Cerebral arteriography showed the absence of the normal vas cular anatomy at the level of the circle of Willis, The intracraneal vessel s presented severe stenosis or were occluded and replaced by an extensive n etwork of ectasic collateral vessels. Abdominal ultrasound examination iden tified asymmetric kidneys, and renal arteriography showed a tight stenosis of the ostium and proximal segment of right main artery, which was only par tially relieved by balloon angioplasty. A saphenous bypass from aorta to th e right renal artery re-established the renal blood flow. Blood pressure dr opped after surgery and was controlled with low doses of diuretic and beta- blocker. After arteriography he presented right haemiplegia, with partial r ecovering in the following months, In conclusion, we described the first ca se of Moyamoya disease with concomitant renovascular disease in a young adu lt of African origin, an association that may be more frequent than usually suspected in clinical practice.