Sixteen children with moyamoya disease and involvement of the posterior cerebral artery are reported from the Departments of Neurophysiology, Neurosurgery, and Radiology, Faculty of Medicine, Kyushu University, Fukuoka, Japan. Eight patients had complete occlusion of posterior cerebral arteries and the other eight had nonocclusive disease. All patients showed patent ophthalmic arteries bilaterally. Pattern-reversal visual-evoked potentials showed abnormalities in 75% of the posterior cerebral artery occlusive group and no abnormalities in the nonocclusive group. Abnormalities were also found in positron emission tomography, computed tomography, and the clinical examination of the visual fields. The authors concluded that the pattern-reversal visual-evoked potentials was the most practical means to explore posterior cerebral artery occlusion in the course of moyamoya disease. [1]

COMMENT. Moyamoya disease is characterized by progressive occlusion of cerebral arteries and predominantly the anterior and middle cerebral arteries. The incidence of posterior cerebral artery involvement and visual disturbances is approximately 25% and the clinical manifestations include decreased visual acuity, homonymous hemianopsia, constriction of the visual fields, and scintillating scotoma.