Neurologists and neurosurgeons of the National Medical Research Center named after. V.A. Almazov saved a patient with a rare genetic pathology of cerebral vessels, giving her the first opportunity to give birth to a child.
A 24-year-old pregnant patient was admitted to the antenatal department of the Perinatal Center of the National Medical Research Center named after. V.A. Almazov due to previously occurring symptoms indicating focal brain damage. Since MR angiography with contrast agent is not possible during pregnancy, the decision was made to wait until delivery.
At 39 weeks of pregnancy, a healthy boy was born. The birth went without complications, but on the second day the woman lost mobility in her left arm and leg. Based on the results of emergency studies (MRI, MSCT angiography of cerebral vessels), Moyamoya disease was diagnosed. The progressive disease is manifested by multiple narrowings (up to complete closure) of the lumens of large arteries, resulting in the development of circulatory failure in various areas of the brain.
It was decided to carry out urgent surgery on the vessels of the right hemisphere of the brain, which suffers most from a lack of blood supply. In the postoperative period, during therapy, movements in the left hand were restored, weakness in the left leg gradually decreased, but speech impairments persisted. Three weeks later, a second similar operation was performed on the left hemisphere of the brain.
Now all the motor and speech functions of the young mother are returning to normal, she has been transferred from intensive care. Dynamic monitoring will continue.
The disease diagnosed in the patient is rare and is more often detected in residents of the eastern regions of Russia, Japan, and China. In adults, it can lead to ischemic stroke with motor, sensory and speech disorders. Surgical methods of treating the disease are the most effective; they allow the creation of bypass arterial pathways.