Case of the month : cocaine induced Moyamoya
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Moyamoya is a disease that was first reported in Japan, in the 1960s. It is a rare and progressive disorder that affects the arteries at the base of the brain, leading to the occlusion of the distal internal carotids and their major branches, including the proximal segments of the middle and anterior cerebral arteries. The stenosis that occurs leads to poor blood flow to those areas that each artery serves. A “hazy puff of smoke” is the characteristic appearance on imaging studies, resulting from the irregular perforating vascular networks found near these stenotic vessels.