Subcortical vascular dementia caused by bilateral internal carotid artery occlusion (Moyamoya) in a 47-year-old Hispanic woman

We report a case of subcortical vascular dementia in a young Hispanic woman, without vascular risk factors, who was found to have extensive ischemic brain lesions due to bilateral intracranial carotid artery occlusions (Moyamoya disease). A combination of ECIC surgeries, donepezil and antiplatelet therapy resulted in increased cerebral perfusion, improvement of cognitive deficits, and prevention of further ischemic or hemorrhagic strokes. Moyamoya disease has been rarely described as a cause of vascular dementia. Differential diagnosis includes atherosclerotic disease, multiple sclerosis, and CADASIL.