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Song JW, Rafla SD, Obusez EC, Raymond SB, Gurol EM, Schaefer PW, Romero JM. High resolution vessel wall MR imaging in prestenotic intracranial atherosclerotic disease. J Clin Neurosci 2019; 63:278-280. [PMID: 30683465 DOI: 10.1016/j.jocn.2019.01.008] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/13/2018] [Accepted: 01/03/2019] [Indexed: 10/27/2022]
Abstract
Vessel wall MR imaging (VWI) may be able to highlight vulnerable intracranial atherosclerosis with vessel wall enhancement thereby serving as a biomarker for symptomatic prestenotic intracranial atherosclerotic disease. We present a case of intracranial hemorrhage presumably due to intracranial atherosclerotic disease (ICAD) identified by VWI and silent on lumen-based imaging modalities. A 66-year-old female presented with sudden onset headache and dysarthria. A head CT showed intracranial hemorrhage centered in the right basal ganglia. Further imaging by CT angiography, MR angiography and a conventional catheter angiogram were negative. MRI of the brain, including VWI, showed abnormal enhancement in the right middle cerebral artery vessel wall, suggesting intracranial atherosclerotic changes in a prestenotic vessel. As a potential noninvasive screening test, VWI could impact patients with ICAD and become part of a stroke risk stratification algorithm.
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Affiliation(s)
- Jae W Song
- Department of Radiology, Division of Neuroradiology, Massachusetts General Hospital, 55 Fruit Street, Boston, MA, USA.
| | - Samuel D Rafla
- Department of Radiology, Division of Neuroradiology, Massachusetts General Hospital, 55 Fruit Street, Boston, MA, USA.
| | - Emmanuel C Obusez
- Department of Radiology, Division of Neuroradiology, Massachusetts General Hospital, 55 Fruit Street, Boston, MA, USA.
| | - Scott B Raymond
- Department of Radiology, Division of Neuroradiology, Massachusetts General Hospital, 55 Fruit Street, Boston, MA, USA.
| | - Edip M Gurol
- Department of Neurology, Massachusetts General Hospital, 55 Fruit Street, Boston, MA, USA.
| | - Pamela W Schaefer
- Department of Radiology, Division of Neuroradiology, Massachusetts General Hospital, 55 Fruit Street, Boston, MA, USA.
| | - Javier M Romero
- Department of Radiology, Division of Neuroradiology, Massachusetts General Hospital, 55 Fruit Street, Boston, MA, USA.
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