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April 1979

Carotid Arterial Occlusion in Identical Twins With Moyamoya

Author Affiliations

Institute of Neurology Government General Hospital Madras, India

Arch Neurol. 1979;36(4):253-254. doi:10.1001/archneur.1979.00500400107025

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To the Editor.—  We recently observed carotid arterial occlusion in identical twins, one of whom also had moyamoya.

Report of Cases.—  Case 1.—A 2-year-old boy, the first of identical twins, was admitted to our Institute of Neurology in October 1974 with left hemiparesis and dysphasia of two days' duration. There was no history of head injury, fever, convulsions, or ear infection. Carotid arterial pulsations were normal. Routine laboratory test results and the CSF were normal. A Mantoux test with PPD strength of 5TU/ 0.1 mL was negative. The EEG showed slow waves on the right. Right carotid angiography showed occlusion of the internal carotid artery at the siphon and a leash of vessels surrounding that region, typical of moyamoya. The child displayed normal speech and residual hemiparesis three years later.Case 2.—The second of the twins, a 4-year-old boy was hospitalized in February 1976 with sudden loss of speech and

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