Background Moyamoya is a rare cerebrovascular disorder seen predominantly in Asian populations. Methamphetamine use is a recognised cause of stroke in young people, but its pathophysiology is not fully understood. The incidence of moyamoya vasculopathy in methamphetamine-associated stroke is unknown due to a lack of sufficient data. We present a rare case of moyamoya syndrome in a young Caucasian woman with methamphetamine-associated stroke. Case A 31-year-old Caucasian woman presented with progressive right arm weakness, speech disturbance and seizures on a background of escalating methamphetamine use in the 9 months prior to admission. She did not have a personal or family history of stroke. MRI revealed both embolic and watershed infarcts in bilateral frontal regions and CT angiography showed development of new lenticulostriate collateral vessels. Digital subtraction angiography confirmed steno-occlusive disease of the bilateral anterior circulations and a ‘puff of smoke’ appearance. Conclusion In young patients who present with stroke with unclear aetiology, it is important to obtain a thorough substance use history. Moyamoya vasculopathy should be considered when evaluating the pathophysiology of stroke in young people.

中文翻译：

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一名年轻高加索女性使用大量甲基苯丙胺的烟雾病血管病变

背景烟雾病是一种罕见的脑血管疾病，主要见于亚洲人群。甲基苯丙胺的使用是年轻人中风的公认原因，但其病理生理学尚不完全清楚。由于缺乏足够的数据，甲基苯丙胺相关卒中中烟雾病血管病变的发病率尚不清楚。我们在一名患有甲基苯丙胺相关中风的年轻高加索女性中报告了一个罕见的烟雾病综合征病例。病例 一名 31 岁的白人女性在入院前 9 个月内因使用不断增加的甲基苯丙胺而出现进行性右臂无力、言语障碍和癫痫发作。她没有中风的个人或家族史。MRI 显示双侧额叶区域的栓塞和分水岭梗塞，CT 血管造影显示新的豆纹侧支血管的发展。数字减影血管造影证实双侧前循环的狭窄闭塞性疾病和“烟雾”外观。结论 对于病因不明的中风年轻患者，了解完整的物质使用史非常重要。在评估年轻人中风的病理生理学时，应考虑烟雾病血管病变。