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2015 ; 2015
(ä): 356582
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Nonstenotic Culprit Plaque: The Utility of High-Resolution Vessel Wall MRI of
Intracranial Vessels after Ischemic Stroke
#MMPMID26346855
de Havenon A
; Yuan C
; Tirschwell D
; Hatsukami T
; Anzai Y
; Becker K
; Sultan-Qurraie A
; Mossa-Basha M
Case Rep Radiol
2015[]; 2015
(ä): 356582
PMID26346855
show ga
Intracranial atherosclerotic disease (ICAD) accounts for 9-15% of ischemic stroke
in the United States. Although highly stenotic ICAD accounts for most of the
strokes, it is assumed that nonstenotic ICAD (nICAD) can result in stroke,
despite being missed on standard luminal imaging modalities. We describe a
patient with nICAD who suffered recurrent thromboembolic stroke and TIA but had a
negative conventional stroke workup. As a result, they were referred for
high-resolution magnetic resonance imaging (HR-MRI) of the arterial vessel wall,
which identified a nonstenotic plaque with multiple high-risk features,
identifying it as the etiology of the patient's thromboembolic events. The
diagnosis resulted in a transition from anticoagulation to antiplatelet therapy,
after which the patient's clinical events resolved. HR-MRI is an imaging
technique that has the potential to guide medical management for patients with
ischemic stroke, particularly in cryptogenic stroke.