Occlusive disease of the internal carotid arteries with vascular collaterals (moyamoya disease) in pregnancy.

A 29 year-old pregnant woman with occlusive disease of the internal carotid arteries and formation of collateral networks (moyamoya disease) is reported. Because of moyamoya disease and toxemia of pregnancy, cesarean section was performed at the 38th week of pregnancy. The patient had a second intracranial hemorrhage 7 months after cesarean section. Encephalo-duro-arterio synangiosis (EDAS) was performed for the prevention of further intracranial hemorrhage and at present she is well. Since intracranial hemorrhage is sometimes associated with bearing down and since hyperventilation-induced cerebral ischemia and hypertension are provoked by active labor, elective cesarean section may be recommended for pregnant women with moyamoya disease.