Concomitant cerebral infarction and intraventricular hemorrhage in moyamoya disease. Case report.

Moyamoya disease is categorized as either ischemic or hemorrhagic type, and the pathogenesis of this disease is unknown. In this paper, the authors report on a patient with moyamoya disease who suffered concomitant cerebral infarction and intraventricular hemorrhage (IVH). Endoscopic removal of the intraventricular hematoma and ventricular drainage were both performed. The patient did not experience further ischemic complications. Patients with moyamoya disease have intracranial hemodynamic insufficiency. Adequate control of intracranial pressure and removal of the intraventricular hematoma is important to prevent progression of cerebral infarction and hydrocephalus. To the authors' knowledge, this is the first report of concomitant cerebral infarction and IVH, or true mixed-type moyamoya disease. A possible pathogenesis of this rare condition is discussed.