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Moyamoya disease (MMD) is a cerebrovascular occlusive disorder which causes recurrent strokes and transient ischemic attacks in children. The arteriopathy of MMD targets the internal carotid arteries (ICA) and their branches resulting in ischemia of the ICA circulation. Small perforator branches of the ICA dilate to provide collateral perfusion to ischemic areas. This small vessel dilatation creates the characteristic angiographic appearance that gives the disease its name (“moyamoya” after the Japanese expression for “something hazy just like a puff of cigarette smoke drifting in the air”). Best medical management involves the prevention of thromboembolic events with antiplatelet agents, maintaining adequate hydration, and avoidance of hyperventilation which can contribute to cerebral vasoconstriction. Presently there are no definitive medical options to halt or correct the process of MMD. Surgical procedures …