**1. Introduction**

Takeuchi and Shimizu Takeuchi first described Moyamoya disease, in 1957 [1]. The term "Moyamoya" was coined to this illness due to its angiographic appearance of "something hazy, like a puff of cigarette smoke" (Moyamoya in Japanese) [1] "Moyamoya disease" (MMD) and "Moyamoya syndrome" (MMS) are both chronic cerebrovascular diseases affecting distal internal carotid and proximal portions of the anterior and middle cerebral arteries [2]. Though Moyamoya disease and Moyamoya syndrome are used synonymously, a subtle distinction separates these two entities. Moyamoya vasculopathy in those with underlying risk factors are described under the umbrella term "Moyamoya syndrome", thus a wide variety of conditions can incite a Moyamoya vasculopathy, however, if a similar angiographic appearance is evident in those with no risk factors, except for an underlying genetic predisposition, it is entitled as "Moyamoya disease" [2]. One more distinction is the" bilateral "angiographic appearance pathognomonic for Moyamoya disease, whilst" unilateral "vasculopathy always qualifies to a Moyamoya syndrome, even without an underlying associated risk factor [2].
