Info Images Findings Impression Reco/Acuity Case Images View Images / Launch Visage Case Notes History 34 yo male SLE w/ renal failure, recent stroke Exam Head MRA Prior Study Dicom View Reference Material
Section 1 Submit Findings Case217d Findings Supratentorial Intradural arterial circulation (for details see Arterial Stroke Module) There is a primary stem intradural/extradural, or proximal intradural ICA high grade stenosis or occlusion. Yes No There is no flow-limiting stenosis or mulicentric stenoses of a secondary stem, division, trunk or pial intracranial artery affecting either the supra or infratentorial arteries. Yes No The circle of Willis is incomplete. Yes No There is is evidence of macrovasculopathy of the proximal intradural ICA with stenoses and or abnormal perforators (both lenticulostriate and/or thalamostriate) representing moyamoya collateralization (disease, syndrome or adult moyamoya forms). Yes No There is evidence of meningeal arteries connecting with pial arteries representing moyamoya collateralization. Yes No There is evidence of collateral re-routing of the intracranial pial arteries. Yes No There is evidence of widespread pial artery stenoses without secondary cause (SAH, encephalitis, meningitis). In a middle age or younger patient distal small vessel stenoses raise the possibility RCVS (reversible angiitis in younger patients), versus primary CNS angiopathy (PACNS), diabetic vasculopathy or inherited CADASIL syndrome in young and middle aged adults. Yes No There is evidence of widespread proximal and/or distal vasospasm in the context of pregancy, or complications of drug therapy, and associated with thunderclap headaches in younger patient to suggest reversibel vasospastic disorder (RCVS) or migraine vasculopathy. Yes No Infratentorial Intradural arterial circulation (for details see Arterial Stroke Module) There is high cervical or intradural vertebral artery thrombosis. Yes No There is stenosis or thrombosis of all or part of the basilar artery. Yes No Given there is high-grade stenosis or thrombosis of the basilar artery, there is adequate retrograde collateral filling the distal basilar & its branches. Yes No There is high grade stenosis or thrombosis of all or part of the superior cerebellar artery (SCA)anterior inferior cerebellar artery (AICA), the posterior inferior cerebellar artery (PICA). Yes No Supra & infratentorial venous Circulation (for details see Venous Stroke Module) There is reduced venous egress, stasis, or thrombosis of the deep venous system (septal veins, thalamostriate veins & ICV's, vein of Galen and deep medullary veins). Yes No There is reduced venous egress, stasis, or thrombosis of the major cerebral (frontal veins, veins of Trolard, veins of Labbe', superior sylvian veins, basal vein of Rosenthal or any of the posterior fossa veins). Yes No There is acute dural sinus stenosis or thrombosis (sagittal, transverse, straight, transverse, torcula, sigmoid, jugular bulb). Yes No There is increased or decreased blood flow through the mesial or lateral tentorial venous confluence, the vertex venous confluence, the sphenoparietal sinus/cavernous sinuses, inferior petrosal sinus. Yes No Other No other abnormalities are noted. Yes No