# Moyamoya Disease Causing Stroke in the Setting of Cocaine Use and Uncontrolled Hypertension Due to Primary Hyperaldosteronism

## TL;DR

A young patient with moyamoya disease experienced stroke due to cocaine use, uncontrolled hypertension, and primary hyperaldosteronism, highlighting a rare and complex clinical case.

## Contribution

This case uniquely links moyamoya disease with hyperaldosteronism, hypertension, cocaine use, and psychiatric features.

## Key findings

- Moyamoya disease can present with stroke in the context of cocaine use and uncontrolled hypertension.
- Primary hyperaldosteronism may contribute to the severity of moyamoya-related complications.
- Psychiatric features may be exacerbated by cocaine use in moyamoya patients.

## Abstract

Moyamoya disease is a cerebrovascular disease characterized by stenosis of large intracranial arteries and the development of smaller collateral vessels. Moyamoya may cause strokes and stroke-like symptoms in young patients. It has also been linked to autoimmune diseases and neuropsychiatric conditions. We present a case of moyamoya disease in a young patient with concomitant hyperaldosteronism, uncontrolled hypertension, and cocaine use disorder, along with features of antisocial personality disorder. This is a unique presentation of an underlying neurological disease causing psychiatric features exacerbated by cocaine use, and it describes a rare clinical presentation that physicians should consider in patients with moyamoya disease.