Moyamoya syndrome

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  • Patient presented with acute left sided weakness.
  • The initial MRI showed acute infarcts the superficial and deep borderzones of the right MCA.
  • MRA showed an occlusive vasculopathy of the terminal ICAs and proximal MCAs with many basal and cortical (mainly PCA) collaterals.
  • Vessel wall imaging showed concentric enhancement of the right terminal ICA and A1 ACA.

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  • 50-year-old patient with repeated transient ischaemic attacks localising to the left cerebral hemisphere.
  • There was a severe stenosis in the left MCA and a moderate short segment stenosis in the right MCA.
  • Associated with the severe left MCA stenoses, there was concentric enhancement that persisting for at least 2 years.