Moyamoya Disease symptoms in adults
Moyamoya disease is a rare, progressive cerebrovascular disorder characterized by the narrowing of arteries at the base of the brain, particularly the internal carotid arteries and their main branches. Although it is more commonly diagnosed in children, adults can also be affected, often presenting with distinct symptoms that reflect the disease’s impact on cerebral blood flow. Recognizing these symptoms is crucial for timely diagnosis and intervention, which can significantly reduce the risk of stroke and neurological damage.
In adults, the presentation of moyamoya disease can be quite varied. One of the most common symptoms is transient ischemic attacks (TIAs), which are brief episodes of neurological dysfunction caused by temporary disruption of blood flow to the brain. These episodes may manifest as sudden weakness or numbness, primarily on one side of the body, or as difficulty speaking or understanding speech. Because TIAs are often fleeting, they can be mistaken for other conditions, making awareness vital.
Ischemic strokes are another significant concern among adults with moyamoya. Unlike in children, where strokes tend to be ischemic, adults are at a higher risk of hemorrhagic strokes due to fragile, abnormal blood vessels that develop as the disease progresses. These hemorrhages can cause sudden, severe neurological deficits, including paralysis, loss of coordination, severe headache, or even coma. The risk of hemorrhage underscores the importance of early detection and management.
Chronic headaches are frequently reported by adults with moyamoya, often described as persistent or recurrent headaches that may be mistaken for migraines. These headaches result from abnormal blood vessel formation and altered cerebral blood flow. Some patients also experience dizziness, fainting spells, or episodes of confusion, especially during exertion or emotional stress when the brain’s demand for blood increases.
In some cases, moyamoya disease can present with neurological symptoms like seizures. Seizures occur due to ischemic or hemorrhagic brain injury caused by compromised blood vessels. Patients may experience convulsions, loss of consciousness, or unusual sensations, which can be alarming and require immediate medical attention.
It is noteworthy that the symptoms can develop gradually, or they may appear suddenly. The variability in presentation depends on the extent of artery narrowing, the severity of collateral blood vessel formation, and whether bleeding occurs. This heterogeneity makes diagnosis challenging, emphasizing the importance of imaging studies such as magnetic resonance angiography (MRA), computed tomography angiography (CTA), or cerebral angiography, which reveal characteristic “puff of smoke” collateral vessels typical of moyamoya.
Overall, adults with moyamoya disease often experience a combination of ischemic symptoms, such as TIAs and strokes, along with headaches, dizziness, and neurological disturbances. Recognizing these signs early can facilitate appropriate diagnostic testing and intervention, including surgical revascularization procedures, which can improve cerebral blood flow and reduce future stroke risk.
Understanding the symptoms of moyamoya in adults is essential for both clinicians and patients, as early diagnosis can dramatically alter the disease course and improve quality of life. If experiencing unexplained neurological symptoms, seeking prompt medical evaluation is vital to prevent severe outcomes.
