Case 211

Medical history

9-year-old male patient with SS hemoglobinopathy, followed at Hemominas' clinic in Belo Horizonte. In 2010, it was carried out examination of transcranial Doppler, which showed increased blood flow velocity in the middle cerebral arteries bilaterally, showing high risk for ischemic stroke, and it was initiated transfusion regimen for primary prevention of the event. It was then ordered an MRI of the brain and its angiographic reconstruction (attached images).

Based on clinical history and the submitted images, which is the most likely diagnosis?

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