Vessel Wall MRI to Differentiate Between Reversible Cerebral Vasoconstriction Syndrome and Central Nervous System Vasculitis

• DOI: 10.1161/strokeaha.111.626184
• Publication Date: 2011-12-09T07:29:06Z
• Authors: Daniel M. Mandell; Charles C. Matouk; Richard I. Farb; Timo Krings; Ronit Agid; Karel terBrugge; Robert A. Willinsky; Richard H. Swartz; Frank L. Silver; David J. Mikulis
• Keywords: Cerebral vasculitis; Magnetic resonance angiography

Prospective differentiation between reversible cerebral vasoconstriction syndrome and central nervous system vasculitis can be challenging. We hypothesized that high-resolution vessel wall MRI would demonstrate arterial enhancement in but not syndrome.We identified all patients with multifocal segmental narrowing of large intracranial arteries who had follow-up angiography at our institute over a 4-year period performed detailed chart review.Three lacked enhancement, these reversal within 3 months. Four demonstrated persistent or progressive median 17 months (range, 6-36 months) final diagnoses (3) cocaine vasculopathy (1).Preliminary results suggest contrast-enhanced may enable vasculitis.