Moyamoya disease with precocious puberty and pustular psoriasis

An 8-year-old girl suffering from precocious puberty and pustular psoriasis with moyamoya disease is described. The possibilities of a causal relationship between precocious puberty and moyamoya disease are discussed. The relevance of the patient's earlier upper respiratory tract infections to the pustular psoriasis and moyamoya disease is also considered.

Regional cerebral hemodynamics during re-build-up phenomenon in childhood moyamoya disease. An analysis using 99mTc-HMPAO SPECT

We investigated the role of ischemic hypoxia in the appearance of re-build-up phenomenon on electroencephalography in childhood moyamoya disease using 99mTc-hexamethyl propyleneamine oxime and single photon emission computed tomography (99mTc-HMPAO SPECT). In the case reported on, critical reduction of regional cerebral blood flow (rCBF) was observed during re-build-up phenomenon in the bilateral parieto-occipital area where acetazolamide testing revealed severe impairment of the perfusion reserve. On electroencephalography, the re-build-up phenomenon originated in these areas. In addition, re-build-up phenomenon developed into the entire hemisphere 30 s later, even where the severe ischemia was not observed. These results suggest that rCBF reduction induced by hyperventilation plays a critical role in the appearance of the re-build-up phenomenon, but other factors such as ischemic hypoxia after hyperventilation are also important in the development of this phenomenon.