Investigations into understanding the pathogenesis of Moyamoya disease have shown involvement of the CSF basic Fibroblast growth factor (b-FGF) with receptor up-regulation, and TGF beta 1 in altering the cerebral vasculature.[9,21,22] Intimal thickening has also been postulated resulting from altered permeability owing to enhanced prostaglandin release from the arterial smooth muscle.[23]. The gene discussed is FGF2; the disease is Moyamoya disease.