<?xml version="1.0" encoding="ISO-8859-1"?><article xmlns:mml="http://www.w3.org/1998/Math/MathML" xmlns:xlink="http://www.w3.org/1999/xlink" xmlns:xsi="http://www.w3.org/2001/XMLSchema-instance">
<front>
<journal-meta>
<journal-id>0120-8748</journal-id>
<journal-title><![CDATA[Acta Neurológica Colombiana]]></journal-title>
<abbrev-journal-title><![CDATA[Acta Neurol Colomb.]]></abbrev-journal-title>
<issn>0120-8748</issn>
<publisher>
<publisher-name><![CDATA[Asociación Colombiana de Neurología]]></publisher-name>
</publisher>
</journal-meta>
<article-meta>
<article-id>S0120-87482018000100045</article-id>
<article-id pub-id-type="doi">10.22379/24224022178</article-id>
<title-group>
<article-title xml:lang="es"><![CDATA[Síndrome de Moyamoya: una respuesta defensiva al daño crónico de un gran vaso cerebral Reporte de una serie de casos y revisión de la literatura]]></article-title>
<article-title xml:lang="en"><![CDATA[Moyamoya syndrome: a defensive response to the chronic damage of a large cerebral vessel. Cases report and review of the literature.]]></article-title>
</title-group>
<contrib-group>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Jiménez Yepes]]></surname>
<given-names><![CDATA[Carlos Mario]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Patiño Hoyos]]></surname>
<given-names><![CDATA[Manuel Alejandro]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Jiménez Obando]]></surname>
<given-names><![CDATA[Manuela]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
</contrib-group>
<aff id="Af1">
<institution><![CDATA[,Universidad de Antioquia  ]]></institution>
<addr-line><![CDATA[Medellín ]]></addr-line>
<country>Colombia</country>
</aff>
<aff id="Af2">
<institution><![CDATA[,Universidad de Antioquia  ]]></institution>
<addr-line><![CDATA[Medellín ]]></addr-line>
<country>Colombia</country>
</aff>
<aff id="Af3">
<institution><![CDATA[,Universidad Pontificia Bolivariana  ]]></institution>
<addr-line><![CDATA[Medellín ]]></addr-line>
<country>Colombia</country>
</aff>
<pub-date pub-type="pub">
<day>00</day>
<month>03</month>
<year>2018</year>
</pub-date>
<pub-date pub-type="epub">
<day>00</day>
<month>03</month>
<year>2018</year>
</pub-date>
<volume>34</volume>
<numero>1</numero>
<fpage>45</fpage>
<lpage>53</lpage>
<copyright-statement/>
<copyright-year/>
<self-uri xlink:href="http://www.scielo.org.co/scielo.php?script=sci_arttext&amp;pid=S0120-87482018000100045&amp;lng=en&amp;nrm=iso"></self-uri><self-uri xlink:href="http://www.scielo.org.co/scielo.php?script=sci_abstract&amp;pid=S0120-87482018000100045&amp;lng=en&amp;nrm=iso"></self-uri><self-uri xlink:href="http://www.scielo.org.co/scielo.php?script=sci_pdf&amp;pid=S0120-87482018000100045&amp;lng=en&amp;nrm=iso"></self-uri><abstract abstract-type="short" xml:lang="es"><p><![CDATA[RESUMEN  OBJETIVOS: Presentar algunos casos de pacientes con síndrome de Moyamoya secundario a etiologías diversas y con base en ellos revisar aspectos generales del cuadro; de acuerdo con dos de los casos se propone una nueva hipótesis.  MATERIALES Y MÉTODOS: Se describen cuatro casos clínicos de síndrome de Moyamoya, identificados en la ciudad de Medellín, Colombia, con sus respectivas imágenes y la evolución de su cuadro. Con base en dos de los casos, en los cuales el síndrome se desencadenó posteriormente a la implantación de un stent diversor de flujo, se propone una nueva etiología.  RESULTADOS: En dos casos se identificó la implantación de un stent diversor de flujo como el desencadenante del cuadro de Moyamoya. En uno de los casos la enfermedad primaria fue una neurofibromatosis tipo 1; en el cuarto caso no fue posible identificar la causa del síndrome. Ninguno de los pacientes presentó compromiso neurológico a pesar del grave daño arterial.  CONCLUSIONES: El síndrome de Moyamoya (SMM), más que una entidad independiente, debería ser entendido como un mecanismo compensatorio y defensivo secundario a la deprivación del flujo sanguíneo en la circulación cerebral anterior, el cual protege a los pacientes de eventos cerebrovasculares isquémicos con consecuencias devastadoras. La implantación de stents diversores de flujo como método de tratamiento de algunos aneurismas cerebrales, se proyecta en el tiempo como una de las causas más importantes del síndrome.]]></p></abstract>
<abstract abstract-type="short" xml:lang="en"><p><![CDATA[SUMMARY  OBJECTIVES: To present some cases of patients with Moyamoya syndrome secondary to diverse etiologies, and, based on them, to review general aspects of the clinical picture. Supported on two cases, the hypothesis of a new mechanism is proposed.  MATERIALS AND METHODS: Four clinical cases of Moyamoya syndrome are described, identified in the city of Medellín, Colombia, with their respective images and the evolution of their condition. Based on two of the cases, in which the syndrome was triggered after the implantation of a flow-diverter stent, a new etiology is proposed.  RESULTS: In two cases, the implantation of a flow-diverter stent was identified as the trigger of the Moyamoya picture. In one case the primary disease was type 1 neurofibromatosis; in the fourth case it was not possible to identify the cause of the syndrome. None of the patients presented neurological compromise despite severe arterial damage.  CONCLUSIONS: Moyamoya syndrome (MMS), rather than an independent entity, should be understood as a compensatory and defensive mechanism in response to the deprivation of blood flow in the anterior cerebral circulation, which protects patients from ischemic cerebrovascular events. Implantation of flow-diverter stents, as a method of treatment of some cerebral aneurysms, is projected in time as an important cause of this syndrome.]]></p></abstract>
<kwd-group>
<kwd lng="es"><![CDATA[accidente cerebrovascular]]></kwd>
<kwd lng="es"><![CDATA[angiografía cerebral]]></kwd>
<kwd lng="es"><![CDATA[enfermedad de Moyamoya]]></kwd>
<kwd lng="es"><![CDATA[isquemia encefálica]]></kwd>
<kwd lng="es"><![CDATA[neurofibromatosis 1]]></kwd>
<kwd lng="es"><![CDATA[stent (DeCS)]]></kwd>
<kwd lng="en"><![CDATA[Brain ischemia]]></kwd>
<kwd lng="en"><![CDATA[cerebrovascular accident]]></kwd>
<kwd lng="en"><![CDATA[cerebral angiography]]></kwd>
<kwd lng="en"><![CDATA[Moyamoya disease]]></kwd>
<kwd lng="en"><![CDATA[neurofibromatosis 1]]></kwd>
<kwd lng="en"><![CDATA[Stent (MeSH)]]></kwd>
</kwd-group>
</article-meta>
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