Triptan Is Effective for the Migraine with Aura-Like Headache Associated With Moyamoya Disease

We describe two cases of moyamoya disease associated with headache which had been diagnosed as migraine with aura meeting the International Headache Society criteria. Administration of triptan was clinically effective. Initial computed tomography and magnetic resonance imaging of the brain showed no abnormalities, which made the diagnosis of moyamoya disease difficult. We discuss the pathophysiological mechanism of migraine-like headache caused by moyamoya disease. Proper neuroradiological investigation such as MRA may become mandatory even in patients with typical symptom of MWA, because triptans have relative contraindication in patients with moyamaya disease