A rare case of pituitary dysfunction with Moyamoya disease

ABSTRACT

Moyamoya disease is an idiopathic chronic and progressive vaso-occlusive disease ofthe bilateral intracranial branches of the internal carotid artery. Growth hormone failure, thyroid dysfunction, and low cortisol hormones are consequences of hypopituitarism. A 14-year-old girl with short stature presented with right-sided weakness associated with dysarthria. Ahormonal assay test showed abnormality ofthe anterior pituitary hormones. Magnetic resonance imaging of the brain and pituitary gland showed a reduction in the size of the adenohypophysis. A cerebral vessel angiogram showed multiple areas of stenosis in the right internal carotid artery. Magnetic resonance angiography demonstrated stenosis at the suprasellar region of the bilateral internal carotid artery. Pituitary dysfunction associated with moyamoya disease is rare but must be considered as adifferential diagnosis for any patient with hypopituitarism. Hypothalamopituitary dysfunction as result of carotid ischemia might be associated with moyamoya disease. Such patients require close follow-up and hormonal assay tests.