Vol 55, No 1 (2021)
Technical Note
Published online: 2021-01-19

open access

Page views 1070
Article views/downloads 550
Get Citation

Connect on Social Media

Connect on Social Media

Ruptured temporal horn aneurysm associated with Moyamoya collateral vessel coexisting with contralateral arteriovenous malformation — technical note with clinical vignette

Alejandro Feria1, Grzegorz Brzezicki2
Pubmed: 33463697
Neurol Neurochir Pol 2021;55(1):102-106.


The co-occurrence of a brain arteriovenous malformation, Moyamoya Disease, and intracranial aneurysm is exceedingly rare. We report the third case of this disease constellation, and the first where the aneurysm arises from the Moyamoya collateral vessel. We review the relevant literature and discuss proposed pathophysiological mechanisms and clinical implications.

Article available in PDF format

View PDF Download PDF file


  1. Gross B, Du R. Natural history of cerebral arteriovenous malformations: a meta-analysis. Journal of Neurosurgery. 2013; 118(2): 437–443.
  2. Kim H, Al-Shahi Salman R, McCulloch CE, et al. MARS Coinvestigators. Untreated brain arteriovenous malformation: patient-level meta-analysis of hemorrhage predictors. Neurology. 2014; 83(7): 590–597.
  3. Mohr JP, Parides MK, Stapf C, et al. international ARUBA investigators. Medical management with or without interventional therapy for unruptured brain arteriovenous malformations (ARUBA): a multicentre, non-blinded, randomised trial. Lancet. 2014; 383(9917): 614–621.
  4. Herreman F, Nathal E, Yasui N, et al. Intracranial Aneurysms in Moyamoya Disease: Report of Ten Cases and Review of the Literature. Cerebrovascular Diseases. 1994; 4(5): 329–336.
  5. Yu J, Yuan Y, Zhang D, et al. Moyamoya disease associated with arteriovenous malformation and anterior communicating artery aneurysm: A case report and literature review. Exp Ther Med. 2016; 12(1): 267–271.
  6. Mills MT, Zafar A, Choudhari KA, et al. Management of Concomitant Moyamoya Disease, Arterial Venous Malformation, and Intracranial Aneurysm: Case Illustration, Literature Review, and Management Algorithm. World Neurosurg. 2018; 119: 262–266.
  7. Spetzler RF, Martin NA. A proposed grading system for arteriovenous malformations. J Neurosurg. 1986; 65(4): 476–483.
  8. Al-Shahi R, Warlow C. A systematic review of the frequency and prognosis of arteriovenous malformations of the brain in adults. Brain. 2001; 124(Pt 10): 1900–1926.
  9. Friedlander RM. Clinical practice. Arteriovenous malformations of the brain. N Engl J Med. 2007; 356(26): 2704–2712.
  10. Suzuki J, Kodama N. Moyamoya disease--a review. Stroke. 1983; 14(1): 104–109.
  11. Yu JL, Wang HL, Xu K, et al. Endovascular treatment of intracranial aneurysms associated with moyamoya disease or moyamoya syndrome. Interv Neuroradiol. 2010; 16(3): 240–248.
  12. Zhang L, Xu K, Zhang Y, et al. Treatment strategies for aneurysms associated with moyamoya disease. Int J Med Sci. 2015; 12(3): 234–242.
  13. Noh JH, Yeon JeY, Park JH, et al. Cerebral arteriovenous malformation associated with moyamoya disease. J Korean Neurosurg Soc. 2014; 56(4): 356–360.
  14. Mawad ME, Hilal SK, Michelsen WJ, et al. Occlusive vascular disease associated with cerebral arteriovenous malformations. Radiology. 1984; 153(2): 401–408.
  15. Kalani MY, Martirosyan NL, Nakaji P, et al. Microsurgical clipping of an unruptured lenticulostriate aneurysm. J Clin Neurosci. 2012; 19(11): 1578–1580.
  16. Gandhi CD, Gilad R, Patel AB, et al. Treatment of ruptured lenticulostriate artery aneurysms. J Neurosurg. 2008; 109(1): 28–37.
  17. Sakai K, Mizumatsu S, Terasaka K, et al. Surgical treatment of a lenticulostriate artery aneurysm. Case report. Neurol Med Chir (Tokyo). 2005; 45(11): 574–577.
  18. Chalouhi N, Tjoumakaris S, Gonzalez LF, et al. Onyx embolization of a ruptured lenticulostriate artery aneurysm in a patient with moyamoya disease. World Neurosurg. 2013; 80(3-4): 436.e7–436.10.
  19. Ni W, Xu F, Xu B, et al. Disappearance of aneurysms associated with moyamoya disease after STA-MCA anastomosis with encephaloduro myosynangiosis. J Clin Neurosci. 2012; 19(3): 485–487.
  20. Leung GK, Lee R, Lui WM, et al. Thalamo-perforating artery aneurysm in Moyamoya disease - case report. Br J Neurosurg. 2010; 24(4): 479–481.

Neurologia i Neurochirurgia Polska