<prompt> Puff of smoke is a feature ofJoube syndromeMoya Moya diseaseBothNone of the above  <response>: Puff of smoke is a feature of Moya Moya disease on Angiography It is caused due to chronic vasospasm of supraclinoid pa of ICA. IVYS SIGN- Prominent leptomeningeal collaterals in moya-moya disease result in vivid contrast enhancement and high signal on FLAIR due to slow flow. The appearance is reminiscent of the brain having been covered with ivy. Figure: Puff of smoke sign 