In this study, we aimed to identify indicators that could predict the hemispheric manifestation of MMD in terms of genetic and angiographical profiles by analyzing the association of phenotypes (ischemia or hemorrhage) and digital subtraction angiography (DSA) features of each hemisphere with the RNF213 variants by sequencing all exons of RNF213. Additionally, we investigated the association between de novo cerebrovascular events in asymptomatic hemispheres and the genotype of RNF213. This evidence concerns the gene RNF213 and hemorrhage.