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Case Reports
. 2023 May 17;47(5-6):262-268.
doi: 10.1080/01658107.2023.2212756. eCollection 2023.

Moyamoya-Like Vasculopathy and Orbital Trauma: An Association

Jonathan A Alexis  1 , Jane Lock  1   2   3 , Lay Kho  4   5 , Andrew L Thompson  6 , David A Prentice  7
Affiliations
Case Reports

Moyamoya-Like Vasculopathy and Orbital Trauma: An Association

Jonathan A Alexis et al. Neuroophthalmology. .

Abstract

An Asian man in his 20s developed asymptomatic ipsilateral moyamoya-like vascular changes following orbital and head trauma. An ipsilateral traumatic optic neuropathy with extensive optic cupping ensued. The complex embryology of the ocular vascular development is reviewed as having a potential causative role in the intracranial carotid vasculopathy.

Keywords: Moyamoya; ocular embryology; optic neuropathy; vasculopathy.

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Conflict of interest statement

No potential conflict of interest was reported by the authors.

Figures

Figure 1.
Figure 1.
Computed tomography scan of the right optic nerve canal fracture. Image (a) is a 3D reconstruction showing the right optic canal (white arrow) and fractures through the optic canal (white stars). Image (b) shows fractures traversing the right orbital apex and optic canal (white arrows).
Figure 2.
Figure 2.
(a) Right optic nerve showing relative cupping with the appearance of some inferotemporal neuro-retinal rim pallor. (b) Left optic nerve with a normal appearance.
Figure 3.
Figure 3.
Vascular changes on computed tomography angiography (CTA) and magnetic resonance angiography (MRA). Row (a) is CTA on initial presentation with normal bilateral internal carotid arteries (ICA) and right middle cerebral artery (MCA) (white star) vasculature. Row (b) is 3D vascular reconstruction MRA 15 months post injury showing a ‘puff of smoke’ appearance (long white arrow) and loss of flow through the right ICA and MCA (short white arrow) consistent with right-sided moyamoya-like occlusive vasculopathy.
Figure 4.
Figure 4.
Axial T2-weighted magnetic resonance imaging showing hyperintensity of the intracanalicular segment of the right optic nerve (short arrow). Hyperintensity of the orbital fat (long arrow) indicates traumatic oedema.
See this image and copyright information in PMC

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