Fig 4.

A child with Moyamoya disease. Data from an 11-year-old male patient who had left involuntary movement. He underwent indirect bypass surgery on the right cerebral hemisphere. MR imaging of the preoperative (A) and postoperative (B) views shows a decrease in the ivy sign on the right hemisphere after bypass surgery. MRA of the preoperative (C) and postoperative (D) views shows increased flow-related enhancement via the right temporal subcutaneous tissue to the right MCA region after surgery. Quantitative analysis of preoperative (E) and postoperative (F) basal/ACZ stress brain perfusion SPECT. VRs in bilateral MCA territories are impaired preoperatively (E). VR and staging in the right hemisphere are improved postoperatively (F).