From the case: Moyamoya syndrome (with background sickle cell disease)
There is no flow in cavernous segment of the right ICA with reconstitution of the flow in supraclinoid segment and distal branches. There is also narrowing of the supraclinoid segment of the left ICA and MCAs bilaterally with reduced number and calibre of the cortical branches of MCAs. Vertebrobasilar system is relatively spared. There is network of multiple small collateral branches at the base of the brain, ambient cisterns and also intraaxial bilateral basal ganglia region in keeping with moyamoya collaterals.