Moyamoya in a non-Asian patient: a case report and review of the literature.

Moyamoya disease (MMD) has historically been diagnosed in the Japanese population. However, newer studies have demonstrated worldwide distribution. Of note, patients of Appalachian descent with no known Asian ancestry have presented with MMD. We are presenting a case of MMD in an Appalachian, non-Asian patient who presented to the neurosurgical service with a severe headache of four days duration. The patient was found to have multiple hemorrhagic infarcts on CT and was admitted to the ICU. Cerebral angiography findings confirmed the diagnosis of MMD. Our case provides information regarding signs and symptoms, diagnostic neuroimaging findings, and treatment modalities for MMD.