Abstract:
BACKGROUND AND PURPOSE:Intravascular angioplasty and stenting of intracranial arterial stenosis provided controversial results. Besides the expertise of the practitioners, the selection of the patients remains challenging. BOLD MRI of the cerebral vasoreactivity (BOLD MRI CVR) to hypercapnia provides reproducible maps of the entire brain of the vascular reserve, and could be helpful to assess the best therapeutic strategy. CASE HISTORY:We report the case of a 63-year-old woman referred for a severe stenosis of the proximal portion of the left middle cerebral artery, revealed by a lenticulostriate and precentral infarction. Despite an aggressive medical treatment during 5 months, the occurrence of iterative transient ischemic attacks motivated intravascular stenting. Functional MRI of the vasoreactivity to hypercapnia using both Blood Oxygen Level Dependent (BOLD) and arterial spin labeling sequences showed normal basal perfusion and impaired vasoreactivity in the left middle cerebral artery territory. Three months after stenting, the BOLD MRI CVR showed vasoreactivity normalization. Since, the patient remains free of ischemic disorders one year after stenting. CONCLUSION:BOLD MRI of the CVR to hypercapnia may be helpful to optimize the treatment of patients with intracranial arterial stenosis, and could be performed in future therapeutic trials.
journal_name
Hum Brain Mappjournal_title
Human brain mappingauthors
Attyé A,Villien M,Tahon F,Warnking J,Detante O,Krainik Adoi
10.1002/hbm.22255subject
Has Abstractpub_date
2014-04-01 00:00:00pages
1320-4issue
4eissn
1065-9471issn
1097-0193journal_volume
35pub_type
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