Click on image to view larger version.
Fig 3. A 45-year-old woman with Moyamoya disease who presented with right thalamic hemorrhage. Right internal carotid arteriograms in posterior-anterior projection (A) demonstrated that the right ICA, anterior cerebral artery, and proximal MCA are occluded (large black arrow). The right ICA is in stage 4. Slightly developed Moyamoya vessels are seen around the distal ICA (black arrowhead). The distal MCA is visualized through the Moyamoya vessels. Left common carotid arteriogram in lateral projection (B) shows that the left ICA is completely occluded in its proximal portion (white arrowhead). The left internal ICA is in stage 6. Left vertebral arteriogram in posterior-anterior projection (C) shows severe stenosis in the bilateral posterior cerebral arteries (white arrows). Moyamoya vessels are seen in the posterior region of the brain base. Peripheral branches of bilateral posterior cerebral arteries are visualized through Moyamoya vessels. The bilateral posterior cerebral artery is in stage 3. MTT map (D) demonstrates extensive areas of prolonged MTT in bilateral cerebral hemispheres. This map was calculated with the AIF obtained from a right MCA branch.
