Nuclear Medicine Studies Using Pharmacologic Intervention Confirm Both Renovascular Hypertension and Improvement in Cerebral Perfusion After Surgery in a Child With Moyamoya Disease

Moyamoya disease (MMD) is an idiopathic progressive disorder associated with stenosis or occlusion of the cerebral vasculature with particular involvement of the circle of Willis and the arteries that feed it. Renal artery lesions and renovascular hypertension (RVH) in MMD have been described by many authors. Captopril renography is a sensitive screening investigation for RVH in adults and children. Basal/acetazolamide stress brain perfusion SPECT with Tc-99m HMPAO performed in MMD can disclose regions of decreased cerebral perfusion and cerebrovascular reserve, which can be improved by revascularization surgery.