{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,27]],"date-time":"2026-03-27T11:40:43Z","timestamp":1774611643840,"version":"3.50.1"},"reference-count":47,"publisher":"BMJ","content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["BMJ Case Reports"],"accepted":{"date-parts":[[2018,7,6]]},"abstract":"<jats:p>Moyamoya disease is a vasculopathy causing chronic progressive stenosis and occlusion of the large arteries of the circle of Willis that could lead to brain ischaemia. The condition may also present with haemorrhagic strokes. This is a case report of moyamoya disease in a 32-year-old woman presenting with ischaemic stroke. The report describes her inpatient stay and investigations and findings.<\/jats:p>\n               <jats:p>The report reviews the main aspects of moyamoya disease definition, epidemiology, clinical features, diagnosis, classification and treatment. This case is interesting because her first presentation occurred after 3 months of her second delivery. Whether the different physiological stresses of pregnancy, child birth and puerperium have had some effect in accelerating the pathogenesis of her moyamoya disease remains unknown.\n<jats:sup>1<\/jats:sup>\n\n               <\/jats:p>","DOI":"10.1136\/bcr-2017-221685","type":"journal-article","created":{"date-parts":[[2018,8,9]],"date-time":"2018-08-09T09:54:40Z","timestamp":1533808480000},"page":"bcr-2017-221685","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":2,"title":["Peek through the smoke: a report of moyamoya disease in a 32-year-old female patient presenting with ischaemic stroke"],"prefix":"10.1136","volume":"2018","author":[{"given":"Siddiq","family":"Omer","sequence":"first","affiliation":[{"name":"Care of the Elderly Medicine, Mid Essex Hospital Services NHS Trust, Chelmsford, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Renata","family":"Zbyszynska","sequence":"additional","affiliation":[{"name":"Mid Essex Hospital Services NHS Trust, Chelmsford, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ramanathan","family":"Kirthivasan","sequence":"additional","affiliation":[{"name":"Mid Essex Hospital Services NHS Trust, Chelmsford, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"239","published-online":{"date-parts":[[2018,8,9]]},"reference":[{"key":"2025082706464600000_2018.aug09_2.bcr-2017-221685.1","first-page":"161","article-title":"Moyamoya disease in pregnancy: a case series and review of management options","volume":"70","author":"Ma","year":"2011","journal-title":"Hawaii Med J"},{"key":"2025082706464600000_2018.aug09_2.bcr-2017-221685.2","first-page":"31","article-title":"[Autoimmune antibody in moyamoya disease]","volume":"14","author":"Wanifuchi","year":"1986","journal-title":"No Shinkei Geka"},{"key":"2025082706464600000_2018.aug09_2.bcr-2017-221685.3","first-page":"229","article-title":"Moyamoya disease: a review of clinical research","volume":"70","author":"Hishikawa","year":"2016","journal-title":"Acta Med Okayama"},{"key":"2025082706464600000_2018.aug09_2.bcr-2017-221685.4","doi-asserted-by":"publisher","DOI":"10.1097\/00006123-199604000-00028"},{"key":"2025082706464600000_2018.aug09_2.bcr-2017-221685.5","doi-asserted-by":"crossref","first-page":"329","DOI":"10.1159\/000108503","article-title":"Intracranial Aneurysms in Moyamoya disease: report of ten cases and review of the literature","volume":"4","author":"Herreman","year":"1994","journal-title":"Cerebrovasc Dis"},{"key":"2025082706464600000_2018.aug09_2.bcr-2017-221685.6","doi-asserted-by":"publisher","DOI":"10.1016\/S0303-8467(97)00031-0"},{"key":"2025082706464600000_2018.aug09_2.bcr-2017-221685.7","doi-asserted-by":"publisher","DOI":"10.1212\/01.wnl.0000176066.33797.82"},{"key":"2025082706464600000_2018.aug09_2.bcr-2017-221685.8","doi-asserted-by":"publisher","DOI":"10.1038\/jhg.2010.132"},{"key":"2025082706464600000_2018.aug09_2.bcr-2017-221685.9","doi-asserted-by":"publisher","DOI":"10.1212\/WNL.0b013e318249f71f"},{"key":"2025082706464600000_2018.aug09_2.bcr-2017-221685.10","doi-asserted-by":"crossref","first-page":"876","DOI":"10.3346\/jkms.2003.18.6.876","article-title":"Associations of Moyamoya patients with HLA class I and class II alleles in the Korean population","volume":"18","author":"Han","year":"2003","journal-title":"J Korean Med Sci"},{"key":"2025082706464600000_2018.aug09_2.bcr-2017-221685.11","doi-asserted-by":"publisher","DOI":"10.1136\/jnnp.2006.096040"},{"key":"2025082706464600000_2018.aug09_2.bcr-2017-221685.12","doi-asserted-by":"publisher","DOI":"10.1136\/jnnp.2006.096040"},{"key":"2025082706464600000_2018.aug09_2.bcr-2017-221685.13","doi-asserted-by":"crossref","first-page":"182","DOI":"10.1159\/000121249","article-title":"Elevation of cerebrospinal fluid levels of basic fibroblast growth factor in moyamoya and central nervous system disorders","volume":"27","author":"Malek","year":"1997","journal-title":"Pediatr Neurosurg"},{"key":"2025082706464600000_2018.aug09_2.bcr-2017-221685.14","doi-asserted-by":"publisher","DOI":"10.3171\/jns.1998.89.4.0623"},{"key":"2025082706464600000_2018.aug09_2.bcr-2017-221685.15","doi-asserted-by":"publisher","DOI":"10.1161\/01.STR.0000148237.13659.e6"},{"issue":"Suppl 2","key":"2025082706464600000_2018.aug09_2.bcr-2017-221685.16","doi-asserted-by":"crossref","first-page":"S225","DOI":"10.1016\/S0303-8467(97)00049-8","article-title":"and Epstein-Barr virus infection in moyamoya disease","volume":"99","author":"Tanigawara","year":"1997","journal-title":"Clin Neurol Neurosurg"},{"key":"2025082706464600000_2018.aug09_2.bcr-2017-221685.17","doi-asserted-by":"crossref","unstructured":"Yamada H , Deguchi K , Tanigawara T , et al . 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