KEY FACTS Terminology Hypotensive cerebral infarction (HCI) Infarction resulting from insufficient cerebral blood flow (CBF) to meet metabolic demands (low-flow state) 2 types of border zone or watershed infarcts – Border zone between major arterial territories □ Typically at cortex,…
KEY FACTS Terminology Hypoxic ischemic injury (HII): Global hypoxic ischemic injury, global anoxic injury, cerebral hypoperfusion injury Etiologies: Cardiac arrest, cerebrovascular disease, drowning, asphyxiation Imaging Injury patterns highly variable depending on brain maturity, severity, and length of insult Mild to…
KEY FACTS Terminology Vertebral artery (VA) dissection Irregularity of VA contour from intimal tear or subadventitial hematoma Imaging Stenoocclusive dissection Dissection to subintimal plane with vessel luminal narrowing or occlusion Dissecting aneurysm Dissection into subadventitial plane with dilatation of outer…
KEY FACTS Terminology Internal carotid artery (ICA) dissection (ICAD) ICAD: Tear in ICA wall allows blood to enter & delaminate wall layers Imaging Pathognomonic findings of dissection: Intimal flap or double lumen (seen in < 10%) Aneurysmal dilatation seen in…
KEY FACTS Terminology Fibromuscular dysplasia (FMD) Arterial disease of unknown etiology Overgrowth of smooth muscle, fibrous tissue Affects medium/large arteries Imaging Renal artery is most common overall site (~ 75%) Cervicocranial FMD (~ 70%) Internal carotid artery (ICA) (30-50%) >…
KEY FACTS Terminology Microangiopathy of brain, retina, and cochlea Imaging T2 hyperintense corpus callosum lesions in patient with clinical triad Encephalopathy, bilateral hearing loss, and branch retinal artery occlusions Multifocal T2 hyperintensities similar to MS More often round, midcallosal rather…
KEY FACTS Terminology Chronic, idiopathic relapsing-remitting multisystem vascular-inflammatory disease characterized by recurrent orogenital ulcerations and uveitis CNS involved in up to 20-25% of patients Imaging Best diagnostic clue: T2 hyperintense brainstem lesion in patient with oral and genital ulcers Midbrain…
KEY FACTS Terminology C erebral A utosomal D ominant A rteriopathy with S ubcortical I nfarcts and L eukoencephalopathy ( CADASIL ) Hereditary small-vessel disease due to mutations in NOTCH3 gene on chromosome 19, which causes stroke in young to…
KEY FACTS Terminology Cerebral amyloid deposition occurs in 3 morphologic varieties Common: Cerebral amyloid angiopathy (CAA) Uncommon: Mass-like lesion (amyloidoma) Rare: Inflammatory; diffuse (encephalopathic) white matter involvement Imaging General findings Normotensive demented patient Lobar hemorrhage(s) of different ages Multifocal “black…
KEY FACTS Terminology Systemic lupus erythematosus (SLE), neuropsychiatric (NPSLE), CNS lupus Multisystem autoimmune disorder that affects respiratory, cardiovascular, GI, GU, musculoskeletal systems, and CNS CNS involved in up to 75% Imaging 4 general patterns New infarcts (associated with ↑ anticardiolipin,…