Moya-Moya Disease

This is a patient with sickle cell anemia, a hereditary condition that affects the red blood cells. This MR angiogram of the arterial circulation of the brain reveals complete occlusion of both internal carotid arteries, due to the complications of sickle cell anemia. Extensive collateral vessels are visualized (arrows). These collateral vessels give the "puff-of-smoke" appearance that is characteristic of Moya-Moya disease, a complication of sickle-cell anemia.