PATIENT: Male, 42 FINAL DIAGNOSIS: Moyamoya disease (MMD) Symptoms: Aphasia • 
concentration difficulty • dysarthria • personality change
MEDICATION: - Clinical Procedure: - Specialty: Radiology.
OBJECTIVE: Rare disease.
BACKGROUND: Moyamoya disease (MMD) was first described in 1957 as "hypoplasia of 
the bilateral internal carotid arteries." The characteristic appearance of the 
associated network of abnormally dilated collateral vessels on angiography was 
later likened to "something hazy, like a puff of cigarette smoke," which, in 
Japanese, is Moyamoya. This paper describes the fulminant course of the disease 
in a Hispanic male involving the corpus callosum.
CASE REPORT: A 42-year-old Hispanic male with progressive aphasia, slow 
mentation, and sudden onset of sensorimotor symptoms with gait disturbance was 
found to have multiple intracranial supratentorial infarcts of variable stages 
of evolution involving, but not limited to, the anterior corpus callosum, 
followed by rapid development of further infarcts. Angiography demonstrated 
right ACA occlusion, left supraclinoid ICA occlusion with a Moyamoya pattern of 
collateralization, and diffuse arteriopathy. A fulminant course ensued and the 
patient did not survive the acute phase of ischemic disease.
CONCLUSIONS: Moyamoya disease may rarely present in North American Hispanic 
males, with advanced atypical clinical and imaging features involving the 
anterior corpus callosum and having a fulminant course.