Lipohyalinosis and Miliary Microaneurysms Causing Cerebral Hemorrhage in a Patient with Moyamoya

Moyamoya is an intriguing and controrersial syndrome. This patient study senes to align the patbophysiology of intracranial hemorrhage in moyamoya with the cerebral rascular disease seen with hypertension, or aging. The historical eridence Unking lipohyalinosis and microaneurysms to cerebral hemorrhage is reviewed, the pathogenesis of this angiopathy Is discussed, and explanations considered for its association with the rascular pattern of moyamoya. We propose that bemodynamlcs, genetics or both are among the primary operant etiologic factors.