Pediatric Radiology

, Volume 35, Issue 5, pp 525–528 | Cite as

Morning glory disc anomaly, midline cranial defects and abnormal carotid circulation: an association worth looking for

  • Boon Long Quah
  • Jill Hamilton
  • Susan Blaser
  • Elise Héon
  • Nasrin N. Tehrani
Case Report


We report on a 4-year-old boy who presented to the ophthalmology department for assessment of convergent strabismus. Ophthalmic examination showed a left morning glory optic disc anomaly and retinal detachment. Plain films obtained for investigation of short stature prior to ophthalmic examination revealed delayed bone age. Ophthalmological findings prompted CT and MRI imaging and angiographic investigations. Midline cranial defects and abnormal carotid circulation were identified. These findings may be associated with morning glory optic disc anomaly, and their association is often under-recognized. It is important that clinicians and radiologists be aware of this spectrum of disorders, as the vascular abnormalities may predispose the patient to transient ischemic attacks and strokes. Growth delay may result from hypopituitarism.


Morning glory disc anomaly Moyamoya Abnormal carotid circulation Midline cranial defect Hypopituitarism 


  1. 1.
    Suzuki J, Takaku A, Kodama N, et al (1975) An attempt to treat cerebrovascular ’moyamoya’ disease in children. Child’s Brain 1:193–206Google Scholar
  2. 2.
    Bakri SJ, Siker D, Masaryk T, et al (1999) Ocular malformations, moyamoya disease, and midline cranial defects: a distinct syndrome. Am J Ophthalmol 127:356–357CrossRefPubMedGoogle Scholar
  3. 3.
    Goldhammer Y, Smith JL (1975) Optic nerve anomalies in basal encephalocele. Arch Ophthalmol 93:115–118PubMedGoogle Scholar
  4. 4.
    Hanson MR, Price RL, Rothner AD, et al (1985) Developmental anomalies of the optic disc and carotid circulation—a new association. J Clin Neuro-ophthalmol 5:3–8Google Scholar
  5. 5.
    Komiyama M, Yasui T, Sakamoto H, et al (2000) Basal meningoencephalocele, anomaly of optic disc and panhypopituitarism in association with moyamoya disease. Pediatr Neurosurg 33:100–104CrossRefPubMedGoogle Scholar
  6. 6.
    Krishnan C, Roy A, Traboulsi E (2000) Morning glory disk anomaly, choroidal coloboma, and congenital constrictive malformations of the internal carotid arteries (moyamoya disease). Ophthalmic Genet 21:21–24Google Scholar
  7. 7.
    Massaro M, Thorarensen O, Liu GT, et al (1998) Morning glory disc anomaly and moyamoya vessels. Arch Ophthalmol 116:253–254PubMedGoogle Scholar

Copyright information

© Springer-Verlag 2004

Authors and Affiliations

  • Boon Long Quah
    • 1
  • Jill Hamilton
    • 2
  • Susan Blaser
    • 3
  • Elise Héon
    • 4
  • Nasrin N. Tehrani
    • 4
  1. 1.Singapore National Eye Centre, Department of OphthalmologyKandang Kerbau Women’s and Children’s HospitalSingapore
  2. 2.Division of Endocrinology, Department of PaediatricsThe Hospital for Sick ChildrenTorontoCanada
  3. 3.Department of Diagnostic ImagingThe Hospital for Sick ChildrenTorontoCanada
  4. 4.Department of Ophthalmology and Vision SciencesThe Hospital for Sick ChildrenTorontoCanada

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