A paradoxical phenomenon: hemichorea-hemiballismus resolution after stroke in moyamoya disease

Moyamoya disease is characterized by occlusion of the supraclinoid internal carotid ar-tery that results in the formation of a fine vascular network (moyamoya vessels) at the base of the brain that mimics a puff of smoke on an angiogram.1,2 Its clinical presentation includes transient ischemic attack, stroke, seizure, headache, and cognitive impairment.3 Hemicho-rea is a less-common presentation of moyamoya disease since involuntary movements are only found in 6% of patients throughout their clinical course.4 We present an interesting case of a young female with left hemichorea-hemiballismus that was resolved after an ischemic stroke.