{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,11,26]],"date-time":"2025-11-26T11:06:39Z","timestamp":1764155199403,"version":"3.46.0"},"reference-count":25,"publisher":"MDPI AG","issue":"12","license":[{"start":{"date-parts":[[2025,11,26]],"date-time":"2025-11-26T00:00:00Z","timestamp":1764115200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Neurology International"],"abstract":"<jats:p>Background: Moyamoya syndrome is a moyamoya-like cerebrovascular condition associated with an identifiable underlying condition. Although head trauma has historically been considered a possible contributing factor, it is currently excluded from the Japanese diagnostic criteria. We report a rare case of progressive unilateral moyamoya-like vasculopathy that developed on the ipsilateral chronic subdural hematoma (CSDH) following head trauma, with a decade-long imaging follow-up. Anterior circulation basi-parallel anatomical scanning (BPAS) provided unique insights into the progressive vessel narrowing beyond the vascular lumen, suggesting its potential utility in evaluating such rare vasculopathies. Case Presentation: A 40-year-old man developed a left-sided CSDH after head trauma and underwent burr hole drainage. Although his symptoms resolved, serial magnetic resonance angiography (MRA) over the subsequent 10 years revealed progressive stenosis of the left middle cerebral artery (MCA), ultimately culminating in an occlusion-like appearance. BPAS revealed moyamoya-like collateral vessels in the same hemisphere, a significant reduction in the outer diameter of the left MCA, supporting the presence of structural arterial wall changes that were not apparent on conventional MRA. Single-photon emission computed tomography revealed mildly reduced cerebral blood flow on the affected side, with a difference of less than 5% compared to non-affected side. He remained neurologically non-symptomatic, with no history of transient ischemic attacks or overt ischemic stroke. Conclusions: This case highlights a rare clinical course of progressive ipsilateral moyamoya-like vascular changes following head trauma and burr-hole drainage for CSDH, potentially indicating an association between head trauma, CSDH, and subsequent moyamoya-like collateral vessel development, warranting further investigation. The use of the anterior circulation BPAS contributed to the detection of structural arterial changes that were not apparent on conventional MRA, suggesting its potential utility in evaluating such vascular abnormalities.<\/jats:p>","DOI":"10.3390\/neurolint17120191","type":"journal-article","created":{"date-parts":[[2025,11,26]],"date-time":"2025-11-26T10:04:57Z","timestamp":1764151497000},"page":"191","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Progressive Unilateral Moyamoya-like Vasculopathy After Head Trauma with Chronic Subdural Hematoma: A Case Demonstrating the Utility of Anterior Circulation Basi-Parallel Anatomical Scanning"],"prefix":"10.3390","volume":"17","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-9953-8665","authenticated-orcid":false,"given":"Shinya","family":"Watanabe","sequence":"first","affiliation":[{"name":"Department of Neurosurgery, Mito Kyodo General Hospital, Tsukuba University Hospital Mito Area Medical Education Center, 3-2-7 Miyamachi, Mito 310-0015, Ibaraki, Japan"},{"name":"Department of Neurosurgery, Institute of Medicine, University of Tsukuba, 2-1-1, Amakubo, Tsukuba 305-8576, Ibaraki, Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5799-9965","authenticated-orcid":false,"given":"Yasushi","family":"Shibata","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Mito Kyodo General Hospital, Tsukuba University Hospital Mito Area Medical Education Center, 3-2-7 Miyamachi, Mito 310-0015, Ibaraki, Japan"},{"name":"Department of Neurosurgery, Institute of Medicine, University of Tsukuba, 2-1-1, Amakubo, Tsukuba 305-8576, Ibaraki, Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9224-9767","authenticated-orcid":false,"given":"Eiichi","family":"Ishikawa","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Institute of Medicine, University of Tsukuba, 2-1-1, Amakubo, Tsukuba 305-8576, Ibaraki, Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1968","published-online":{"date-parts":[[2025,11,26]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"e465","DOI":"10.1161\/STR.0000000000000443","article-title":"Adult Moyamoya disease and syndrome: Current perspectives and future directions: A scientific statement from the American Heart Association\/American Stroke Association","volume":"54","author":"Gonzalez","year":"2023","journal-title":"Stroke"},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"409","DOI":"10.1016\/j.wneu.2021.11.026","article-title":"Moyamoya Vasculopathy: Cause, Clinical Manifestations, Neuroradiologic Features, and Surgical Management","volume":"159","author":"Velo","year":"2022","journal-title":"World Neurosurg."},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"307","DOI":"10.2176\/jns-nmc.2022-0072","article-title":"Research Committee on Moyamoya Disease (Spontaneous Occlusion of Circle of Willis) of the Ministry of Health, Labor, and Welfare, Japan. Diagnostic criteria for Moyamoya disease\u20142021 revised version","volume":"62","author":"Kuroda","year":"2022","journal-title":"Neurol. Med. Chir."},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"133","DOI":"10.1016\/S0387-7604(79)80022-4","article-title":"\u2018Moya-moya\u2019 disease caused by cranial trauma","volume":"1","author":"Pineda","year":"1979","journal-title":"Brain Dev."},{"key":"ref_5","first-page":"115","article-title":"Moyamoya syndrome with arteriovenous dural fistula after head trauma","volume":"50","author":"Zaletel","year":"2011","journal-title":"Acta Clin. Croat."},{"key":"ref_6","first-page":"2508","article-title":"Surface appearance of the vertebrobasilar artery revealed on basiparallel anatomic scanning (BPAS)-MR imaging: Its role for brain MR examination","volume":"26","author":"Nagahata","year":"2005","journal-title":"Am. J. Neuroradiol."},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"604","DOI":"10.1161\/01.STR.19.5.604","article-title":"Interobserver agreement for the assessment of handicap in stroke patients","volume":"19","author":"Koudstaal","year":"1988","journal-title":"Stroke"},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"512","DOI":"10.1177\/17474930241297031","article-title":"Diagnosis and management of adult moyamoya angiopathy: An overview of guideline recommendations and identification of future research directions","volume":"20","author":"Rifino","year":"2025","journal-title":"Int. J. Stroke"},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"1227","DOI":"10.3174\/ajnr.A8303","article-title":"MCA Parallel Anatomic Scanning MR Imaging-Guided Recanalization of a Chronic Occluded MCA by Endovascular Treatment","volume":"45","author":"Liu","year":"2024","journal-title":"Am. J. Neuroradiol."},{"key":"ref_10","doi-asserted-by":"crossref","first-page":"103487","DOI":"10.1016\/j.nicl.2023.103487","article-title":"Refined imaging features of culprit plaques improve the prediction of recurrence in intracranial atherosclerotic stroke within the middle cerebral artery territory","volume":"39","author":"Quan","year":"2023","journal-title":"Neuroimage Clin."},{"key":"ref_11","doi-asserted-by":"crossref","first-page":"165","DOI":"10.4103\/1793-5482.142738","article-title":"Chronic Subdural Hematoma Associated With Moyamoya Disease","volume":"9","author":"Takeuchi","year":"2014","journal-title":"Asian J. Neurosurg."},{"key":"ref_12","doi-asserted-by":"crossref","first-page":"778","DOI":"10.1016\/j.jocn.2003.10.028","article-title":"Acute carotid arterial occlusion after burr hole surgery for chronic subdural haematoma in moyamoya disease","volume":"11","author":"Ito","year":"2004","journal-title":"J. Clin. Neurosci."},{"key":"ref_13","doi-asserted-by":"crossref","first-page":"622","DOI":"10.2176\/nmc.24.622","article-title":"Resolved chronic subdural hematoma associated with acute subdural hematoma in moyamoya disease","volume":"24","author":"Matsumura","year":"1984","journal-title":"Neurol. Med. Chir."},{"key":"ref_14","doi-asserted-by":"crossref","first-page":"1697","DOI":"10.3174\/ajnr.A2568","article-title":"\u2018Brush Sign\u2019 on susceptibility-weighted MR imaging indicates the severity of Moyamoya disease","volume":"32","author":"Horie","year":"2011","journal-title":"Am. J. Neuroradiol."},{"key":"ref_15","doi-asserted-by":"crossref","unstructured":"Fox, B.M., Dorschel, K.B., Lawton, M.T., and Wanebo, J.E. (2021). Pathophysiology of Vascular Stenosis and Remodeling In Moyamoya Disease. Front. Neurol., 12.","DOI":"10.3389\/fneur.2021.661578"},{"key":"ref_16","doi-asserted-by":"crossref","unstructured":"Leach, D.F., Srivikram Margam, S., Gustin, A., Gustin, P.J., Jajeh, M.N., Chavis, Y.C., Walker, K.V., and Bentley, J.S. (2024). Case Report: A Rare Presentation of Rapidly Progressive Moyamoya Disease Refractory To Unilateral Surgical Revascularization. Front. Surg., 11.","DOI":"10.3389\/fsurg.2024.1409692"},{"key":"ref_17","doi-asserted-by":"crossref","first-page":"423","DOI":"10.1016\/j.surneu.2007.01.078","article-title":"Progressive Moyamoya Syndrome Associated With De Novo Formation of The Ipsilateral Venous and Contralateral Cavernous Malformations: Case Report","volume":"69","author":"Januschek","year":"2008","journal-title":"Surg. Neurol."},{"key":"ref_18","doi-asserted-by":"crossref","first-page":"996","DOI":"10.1111\/ene.12425","article-title":"Association of Moyamoya disease with thyroid autoantibodies and thyroid function: A case-control study and meta-analysis","volume":"21","author":"Lei","year":"2014","journal-title":"Eur. J. Neurol."},{"key":"ref_19","doi-asserted-by":"crossref","unstructured":"Yoshimoto, T., Okune, S., Tanaka, S., Yamagami, H., and Matsumaru, Y. (2025). RNF213-Related Vasculopathy: An Entity with Diverse Phenotypic Expressions. Genes, 16.","DOI":"10.3390\/genes16080939"},{"key":"ref_20","doi-asserted-by":"crossref","first-page":"111","DOI":"10.1038\/s41586-021-03566-4","article-title":"Ubiquitylation of lipopolysaccharide by RNF213 during bacterial infection","volume":"594","author":"Otten","year":"2021","journal-title":"Nature"},{"key":"ref_21","doi-asserted-by":"crossref","first-page":"173","DOI":"10.1161\/STROKEAHA.109.562264","article-title":"Association of thyroid autoantibodies with moyamoya-type cerebrovascular disease: A prospective study","volume":"41","author":"Kim","year":"2010","journal-title":"Stroke"},{"key":"ref_22","doi-asserted-by":"crossref","first-page":"747","DOI":"10.1016\/S1474-4422(22)00165-X","article-title":"Moyamoya disease: Diagnosis and interventions","volume":"21","author":"Ihara","year":"2022","journal-title":"Lancet Neurol."},{"key":"ref_23","doi-asserted-by":"crossref","first-page":"107471","DOI":"10.1016\/j.clineuro.2022.107471","article-title":"Neuroimaging In Moyamoya Angiopathy: Updated Review","volume":"222","author":"Filimonova","year":"2022","journal-title":"Clin. Neurol. Neurosurg."},{"key":"ref_24","doi-asserted-by":"crossref","unstructured":"Liu, W., Morito, D., Takashima, S., Mineharu, Y., Kobayashi, H., Hitomi, T., Hashikata, H., Matsuura, N., Yamazaki, S., and Toyoda, A. (2011). Identification of RNF213 as a susceptibility gene for Moyamoya disease and its possible role in vascular development. PLoS ONE, 6.","DOI":"10.1371\/journal.pone.0022542"},{"key":"ref_25","first-page":"38","article-title":"The CARE guidelines: Consensus-based clinical case reporting guideline development","volume":"2","author":"Gagnier","year":"2013","journal-title":"BMJ Case Rep."}],"container-title":["Neurology International"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/2035-8377\/17\/12\/191\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,11,26]],"date-time":"2025-11-26T10:57:52Z","timestamp":1764154672000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/2035-8377\/17\/12\/191"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,11,26]]},"references-count":25,"journal-issue":{"issue":"12","published-online":{"date-parts":[[2025,12]]}},"alternative-id":["neurolint17120191"],"URL":"https:\/\/doi.org\/10.3390\/neurolint17120191","relation":{},"ISSN":["2035-8377"],"issn-type":[{"value":"2035-8377","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,11,26]]}}}