PMC5215642_01
Preoperative CTA head showing stenosis of supraclinoid parts of bilateral ICA.
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fig1
The patient was finally diagnosed as the case of bilateral moyamoya disease based on CT angiogram, which showed severe bilateral stenosis and occlusion of supraclinoid segments of bilateral internal carotid artery (ICA), middle cerebral artery (MCA), and proximal A1 and bilateral Anterior Cerebral Arteries (ACAs), with an extensive collateral formation and enhanced vascularity in both cerebral hemispheres (please refer to Figure 1).
Postoperative CTA head showing good collateral supply to both cerebral hemispheres.
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fig2
CT angiography was repeated after 6 months from his second surgery and showed improved patency of collateral vessels and better anastomoses (please refer to Figure 2).