Pial synangiosis in 2008 right side: surveillance. MRI: There are postoperative findings related to right pial synangiosis. There is no evidence of intracranial hemorrhage, mass, or acute infarct. The brain parenchyma and pituitary gland appear unremarkable. The ventricles and basal cisterns are normal in size and configuration. There is no midline shift or herniation. The major cerebral flow voids are intact. The orbits are grossly unremarkable.MRA: There is a patent right superficial temporal artery pial synangiosis. There is significant steno-occlusive disease involving the right distal internal carotid artery and proximal right anterior and middle cerebral artery branches. The left internal carotid artery and proximal right anterior and middle cerebral artery branches are grossly intact. There is apparent asymmetrically diminished left posterior cerebral artery flow-related enhancement. The rest of the posterior circulation appears to be intact. There is no evidence of cerebral aneurysms.
1. No evidence of acute intracranial hemorrhage, mass, or acute infarct.2. Findings compatible with moyamoya disease of the right anterior circulation. The left anterior cerebral circulation is intact. 3. Patent right superficial temporal artery pial synangiosis.4. Apparent asymmetrically diminished left posterior cerebral artery flow-related enhancement, which may be artifactual or due to steno-occlusive disease. The rest of the posterior circulation appears to be intact. 