Adult Moyamoya disease.

Background: A 25-year-old African-born female was admitted to the intensive care unit for acute convulsive ictus and headache. Her past medical history was positive for sickle-cell anemia trait with long standing complications, including a chronic ulcer of the left leg treated by a free flap transfer two months previously. She also had a history of long-standing grand mal epilepsy, treated by phenobarbital and diazepam. On admission, the Glasgow score was 10/15. Electroencephalogram showed signs of diffuse brain damage, with right predominance. Sinus venous thrombosis was suspected, based on clinical findings.