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  • Title: High resolution vessel wall MR imaging in prestenotic intracranial atherosclerotic disease.
    Author: Song JW, Rafla SD, Obusez EC, Raymond SB, Gurol EM, Schaefer PW, Romero JM.
    Journal: J Clin Neurosci; 2019 May; 63():278-280. PubMed ID: 30683465.
    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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