The pathogenesis and etiology of MMA are still unknown, even if the association with genetic disorders, the high familial rate, and the strong linkage with variants of the Ring Finger Protein 213 (RNF213)/Mysterin coding gene in East Asian patients strengthen the role of genetic factors in MMA pathogenesis [10,11,12,13,14,15,16,17]. This evidence concerns the gene RNF213 and hereditary disease.