Diabetic Ketoacidosis and Cerebral Infarction Leading to a Diagnosis of Moyamoya Disease

ABSTRACT

There have been few reports of concomitant moyamoya disease (MMD) with type 1 diabetes mellitus. We report a case of MMD associated with type 1 diabetes mellitus in a 9-year-old boy who presented with altered mentality and left side motor weakness. Laboratory test results indicated diabetic ketoacidosis (DKA), but his stuporous mental state and hemiparesis persisted despite DKA management. Brain magnetic resonance imaging revealed multiple cerebral infarcts and stenosis of cerebral arteries with basal collateral vessels, suggesting MMD. After management of DKA and successive surgery for MMD, his hemiparesis improved without further ischemic attacks. Although rare, the possibility of comcomitant MMD should be considered in a type 1 diabetes mellitus patient with neurologic symptoms and cerebral infarction.