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Related Concept Videos

Imaging Studies VII: Vascular Imaging01:19

Imaging Studies VII: Vascular Imaging

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Longitudinal In Vivo Imaging of the Cerebrovasculature: Relevance to CNS Diseases
07:47

Longitudinal In Vivo Imaging of the Cerebrovasculature: Relevance to CNS Diseases

Published on: December 6, 2016

Cerebral vasculitis: imaging signs revisited.

Wilhelm Küker1

  • 1Department of Neuroradiology, West Wing, The John Radcliffe Hospital, Headley Way, Oxford, UK. Wilhelm.Kuker@ndm.ox.ac.uk

Neuroradiology
|March 9, 2007
PubMed
Summary

Diagnosing inflammatory stenoses of cerebral blood vessels, a rare cause of stroke in young adults, involves identifying brain lesions using advanced imaging. Conventional angiography remains crucial for detecting stenoses in smaller brain arteries.

Area of Science:

  • Neurology
  • Radiology
  • Vascular Medicine

Background:

  • Inflammatory stenoses of cerebral blood vessels are rare but significant causes of ischemic stroke in younger individuals.
  • Diagnosis is challenging, often requiring advanced neuroimaging techniques to detect characteristic brain lesions.

Purpose of the Study:

  • To outline the diagnostic process for inflammatory cerebral blood vessel stenoses.
  • To discuss the role of various imaging modalities in identifying brain lesions and vascular pathology.
  • To propose a classification system for cerebral vasculitis.

Main Methods:

  • Utilizing diffusion and perfusion-weighted imaging to identify brain lesions suggestive of cerebral vasculitis.
  • Employing MR angiography for evaluating intracranial vascular stenoses, particularly in large arteries.

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  • Considering conventional angiography for assessing stenoses in medium and small-sized cerebral arteries.
  • Exploring MRI's potential for direct visualization of mural changes in basal arteries.

    • Main Results:

    • Advanced imaging techniques like diffusion and perfusion-weighted imaging frequently detect brain lesions in patients with suspected cerebral vasculitis.
    • Multiple infarcts across different vascular territories may indicate vasculitis.
    • MR angiography is effective for large artery stenoses, while conventional angiography is necessary for smaller vessels.
    • Emerging MRI techniques may visualize arterial wall inflammation, potentially obviating the need for biopsy.

    Conclusions:

    • A systematic approach combining neuroimaging is essential for diagnosing inflammatory cerebral blood vessel stenoses.
    • Cerebral vasculitis diagnosis relies on identifying brain lesions and confirming vascular abnormalities.
    • A proposed classification based on vessel size may standardize the diagnosis of cerebral vasculitis.