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BACKGROUND: Moya-moya disease in children is acerebrovascular disorder that may cause cerebral ischemic orhemorrhage.CASE DETAILS: We report an 8-year-old boy that was admittedwith the chief complaint of repeated sudden half left bodyparalyze. MRA showed acute thrombotic infarction in the righthemisphere and internal carotid artery stenosis in the form ofpuffs of smokes. Indirect revascularization surgical procedurewith combination of Encephalo-myo-pial-synangiosis (EMS) andEncephalo-arterio-pial-synangiosis (EAS) was performed. Itresulted in a good response.CONCLUSION: Moya-moya disease can lead to permanentneurological disability if untreated. Satisfactory outcome wasnoted following combination surgery management with EMS andEAS.