Moyamoya disease [I67.5], Reason for Study: ^Reason: 13 y/o ho brain tumor History: none Brain MRINo evidence of acute ischemic or hemorrhagic lesion.Scattered FLAIR high signal intensity lesions on bilateral centrum semiovale are redemonstrated, unchanged since prior scan.The ventricles, sulci and cisterns are symmetric and unremarkable. There is no mass, mass effect, edema, midline shift, intra or extra-axial fluid collection/hemorrhage, restricted diffusion/acute ischemia. The midline structures and cranial-cervical junction are normal. The paranasal sinuses and mastoid air cells are clear.Brain MRA3D time of flight MOTSA MRA brain images with maximum intensity projections of the anterior/posterior intracranial circulation demonstrate non visualization of the left MCA M1 and proximal M2 segment. The left distal MCA M2 segment is reconstituted and visualized on this MRA. The right distal ICA and proximal right MCA M1 segment show mild to moderate luminal stenosis, considering the difference of imaging technique, it is likely to be unchanged. Bilateral ACA A1 segments' luminal stenosis are again seen, unchanged. Vertebrobasilar system appears to be normal.Neck MRA3D MRA neck post-gadolinium images with maximum intensity projections of the cervical vasculature demonstrate normal flow enhancement in a normal aortic arch origin of the right brachiocephalic, left common carotid, and left subclavian arteries. The vertebral artery origins are normal. There is normal flow enhancement through the bilateral common carotid, carotid bifurcations, internal/external carotid, and vertebral arteries.
1. No evidence of acute ischemic or hemorrhagic lesion.2. Unchanged bilateral centrum semiovale FLAIR high signal intensity lesions since prior scan.3. Progressed obliteration of the left MCA M1 segment. 4. Stable distal right ICA, proximal right MCA M1 segment and bilateral ACA A1 segment stenosis since prior scan.5. Normal neck MRA. 