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.