Postpartum subarachnoid hemorrhage due to Moyamoya disease associated with renal artery stenosis.

Moyamoya disease is a cerebrovascular stenotic or occlusive disease predominantly seen in Asian countries. Sometimes there are coexisting renal artery lesions in Moyamoya disease patients. A 32-year-old multipara had a cesarean section at 33 gestational weeks due to preeclampsia. One month later, she developed subarachnoid hemorrhage and angiography demonstrated Moyamoya vessels with renal artery stenosis. After conservative therapy, the patient was discharged without any deficits. Our conclusion is that patients with Moyamoya disease carry a risk of cerebrovascular accident during pregnancy and postpartum. In this case, we did not diagnose Moyamoya disease with renal artery stenosis until the patient developed subarachnoid hemorrhage. It is very important to make a careful differential diagnosis of hypertension during pregnancy and the postpartum period.