J Korean Child Neurol Soc.  2014 Jun;22(2):98-101.

Headache Associated with Moyamoya Disease in a Child: Pain Pattern in MRA Progression

• Lee WJ
• Kim YO
• Yoon W
• Rho YI
• Woo YJ

Abstract

Headache associated with moyamoya disease (HAMD) has been reported in about 20-30% of pediatric cases with moyamoya disease. However, the characteristic patterns of HAMD during disease progression are not completely known, although much is known on the incidence of HAMD and on the treatment effects of bypass surgery. In a child who presented with HAMD and had no infarction or hemorrhage till bypass surgery, we described the characteristic patterns of headache progression. At first presentation, the patient complained of severe bilateral headache despite mild stenosis only in the left internal carotid artery on brain magnetic resonance angiography. During all stages of progression, headache was severe and pressing in nature rather than throbbing. Nausea and vomiting were present even in the early stage, but photophobia, phonophobia and neck stiffness developed in the late stage. Headache was aggravated by menstruation and was relieved by analgesics and topiramate in the early stage, although the medication failed to provide relief when the headache increased in frequency and duration.

Keyword

Moyamoya disease; Headache; Child

MeSH Terms

Analgesics
Brain
Carotid Artery, Internal
Child*
Constriction, Pathologic
Disease Progression
Female
Headache*
Hemorrhage
Humans
Hyperacusis
Incidence
Infarction
Magnetic Resonance Angiography
Menstruation
Moyamoya Disease*
Nausea
Neck
Photophobia
Vomiting
Analgesics