These findings reinforce the idea of anterior cerebral circulation failure even in RNF213 p.R4810K variant carriers who do not satisfy the diagnostic criteria for MMD (Research Committee on the Pathology, and Treatment of Spontaneous Occlusion of the Circle of Willis, and Health Labour Sciences Research Grant for Research on Measures for Intractable Diseases, 2012). The gene discussed is RNF213; the disease is multiminicore myopathy.