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Rosette Jabbour, MD; Ali Taher, MD; Ali Shamseddine, MD; Samir F. Atweh, MD

Arch Neurol. 2005;62:1144-1146.

Objective  To report a case of proximal occlusion of 2 major cerebral vessels associated with moyamoya network circulation that manifested by spontaneous intraventricular hemorrhage.

Design  Case report.

Patient and Results  A 36-year-old Syrian man presented with symptoms of sudden-onset headache, neck stiffness, and confusion. The computed tomography scan of his brain showed intraventricular bleeding, and the subsequent 4 vessel angiographies revealed occlusion of the left middle and anterior cerebral arteries with moyamoya appearance in the terminal branches. The coagulation profile showed the presence of heterozygous factor V Leiden mutation. The patient was treated conservatively until resolution of his blood clot, and later he was started on oral anticoagulation.

Conclusion  Factor V Leiden mutation may cause large cerebral vessel occlusion with moyamoya syndrome in adults.

Author Affiliations: Department of Internal Medicine, American University of Beirut Medical Center, Beirut, Lebanon.