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Journal of Child Neurology, Vol. 20, No. 7, 620-624 (2005)
DOI: 10.1177/08830738050200071801
© 2005 SAGE Publications

A 10-Year-Old Girl With Coexistent Moyamoya Disease and Graves' Disease

Meredith R. Golomb, MD, MSc

Department of Neurology Division of Pediatric Neurology Indiana University School of Medicine Riley Hospital Indianapolis, Indiana, mgolomb{at}iupui.edu.

Jose Biller, MD

Department of Neurology Loyola University of Chicago Loyola University Medical Center Stritch School of Medicine Chicago, Illinois

Jodi L. Smith, MD

Department of Neurosurgery Indiana University School of Medicine Riley Hospital Indianapolis, Indiana

Mary Edwards-Brown, MD

Department of Neuroradiology Indiana University School of Medicine Riley Hospital Indianapolis, Indiana

Juan C. Sanchez, MD

Department of Pediatrics Section of Pediatric Endocrinology/Diabetology Indiana University School of Medicine Riley Hospital Indianapolis, Indiana

Todd D. Nebesio, MD

Department of Pediatrics Section of Pediatric Endocrinology/Diabetology Indiana University School of Medicine Riley Hospital Indianapolis, Indiana

Bhuwan P. Garg, MBBS

Department of Neurology Division of Pediatric Neurology Indiana University School of Medicine Riley Hospital Indianapolis, Indiana

There are rare reports of young women with moyamoya disease associated with Graves' disease; we are unaware of any previous reports of this association in prepubescent girls. We report a 10-year-old girl who presented with multiple bilateral strokes. Cerebral angiography demonstrated moderate to severe stenosis of her bilateral distal internal carotid arteries and proximal anterior and middle cerebral arteries, which was greater on the right. Thyroid function tests demonstrated suppressed thyroid-stimulating hormone and elevated thyroid hormone levels. Serum antiphospholipid antibody screen demonstrated mild elevations of antiocardiolipin IgG. Possible mechanisms predisposing individuals to concurrent moyamoya and Graves' disease are discussed. (J Child Neurol 2005;20:620—624).


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