CASE REPORT
Introducción: La enfermedad Moyamoya es una arteriopatía idiopática oclusiva de muy escasa aparición en la población hispana, afecta la circulación cerebral anterior de forma bilateral, principalmente a la arteria carótida interna y sus ramas, progresivamente culminan estas en estenosis de sus porciones terminales. El objetivo del trabajo radica en presentar la historia clínica, manejo médico y evolución de un paciente con esta enfermedad a fin de aumentar el conocimiento científico en nuestra región latinoamericana y con ello optimizar las probabilidades de sospecha diagnóstica del personal médico. Presentación de caso: Paciente masculino de 51 años, que acudió al servicio médico por cuadro de lipotimia, cefalea, desequilibrio frente al entorno y vértigo psicógeno. Se presenta el primer caso reportado en Honduras de Enfermedad de Moyamoya, diagnosticado de manera incidental, evaluado en neurocirugía por posible necesidad de drenaje externo, tratado finalmente de manera médica convencional con evolución favorable, actualmente permanece bajo vigilancia neurológica ambulatoria. Discusión: El diagnóstico es un reto, dada la rareza de la enfermedad y la escasez de reportes en latinoamericana, por ello la mayoría de los diagnósticos son incidentales. Conclusión: El manejo adecuado de la enfermedad de moyamoya es causa de debate actualmente, no hay tratamiento conocido que sea curativo. El criterio médico es importante en la elección de la terapia más conveniente según las características propias de cada paciente.
Introduction: Highly rare in the Hispanic population, Moyamoya disease is an occlusive idiopathic arteriopathy that bilaterally affects the anterior cerebral circulation, primarily the internal carotid artery and its branches, progressing to the stenosis of its terminal portions. The aim of this study was to present the clinical history, medical management, and evolution of a patient with this disease to expand scientific knowledge in our Latin American region, thereby optimizing the likelihood of diagnostic suspicion among medical personnel. Case presentation: A 51-year-old male patient visited the medical service due to fainting, headache, imbalance, and psychogenic vertigo. This is the first case of Moyamoya disease to be reported in Honduras. It was incidentally diagnosed, evaluated in neurosurgery for the possible need for external drainage, and ultimately conventionally treated with a favorable prognosis. The patient currently remains under outpatient neurological follow-up. Discussion: The diagnosis of Moyamoya disease is a challenge, given its rarity and the scarcity of reports in Latin America. For this reason, most diagnoses are incidental. Conclusion: The proper management of Moyamoya disease is currently being debated, with no known curative treatment. Medical criteria are important for choosing the most convenient therapy according to each patient’s characteristics.
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1 MD, Neurosurgeon, Neurosurgery Department, Dr. Mario Catarino Rivas Hospital, San Pedro Sula, Cortés, Honduras.
2 MD, General Surgery Department, Dr. Mario Catarino Rivas Hospital, San Pedro Sula, Cortés, Honduras.
3 Student of Medicine, Faculty of Medicine and Surgery, Catholic University of Honduras, San Pedro Sula, Cortés, Honduras.
4 MD, Radiologist, Image and Radiology Departament, Hospital Civil de Guadalajara Fray Antonio Alcalde, Guadalajara, Jalisco, México.
Received: Sep 5, 2022
Accepted: Oct 18, 2022
