Brain infarction following elective laparoscopic cholecystectomy in a patient with sickle cell disease and previously undetected Moyamoya syndrome

Abstract

Objective: We report a 7 year-old boy, known case of sickle cell disease, who underwent laparoscopic cholecystectomy for gallstones. He sustained brain insult due to undiagnosed MoyaMoya syndrome. The purpose of this report is to familiarize the healthcare community with similar events and discuss possible plans/recommendations for future similar cases. Method: Case report and review of the English-language literatures (using PubMed, Ovid, and Proquest databases). Results: Case of complicated MoyaMoya syndrome sustained brain insult postoperatively in a 7 year-old boy, with sickle cell disease and gallstones. Conclusion: Early onset of MoyaMoya syndrome related stroke postoperatively after laparoscopic cholecystectomy is difficult to be assessed immediately. Acute stroke is an infrequent disease of pediatric age group patients. MoyaMoya is a rare cerebrovascular disease of unknown etiology. Our patient is 7 year-old male child who presented immediately postoperatively with abnormal movement of right upper and lower limbs and right upper limb weakness, and no history of MoyaMoya syndrome, which is rare, but important cause of stroke in children. Cerebral revascularization surgery leads to favorable outcome. The present case highlights the importance of considering ''MoyaMoya syndrome'' in sickle cell disease patients who are going for surgery irrespective of their age group. Keywords: Sickle cell disease, Cholecystectomy, Uneventfully, Brain infarction, MoyaMoya syndrome, Hemiparesis