Assessment of pial branches using 7-tesla MRI in cerebral arterial disease.

摘要

A 21-year-old previously healthy man developed several episodes of transient left limb weakness 5 months before the admission. He denied ingesting any drugs or smoking cigarettes. Brain MRI showed an acute ischemic lesion at the right frontal lobe and an old cystic lesion at the right basal ganglia (fig. 1A, B). TFCA showed multifocal narrowing of medium-sized vessels that were compatible with CNS vasculitis (fig. 1C). Laboratory results including anti-double-stranded DNA, c- and p-ANCA, lupus anticoagulant, anticardiolipin antibodies and CSF findings were normal. Brain biopsy, performed on his right frontal lobe, failed to show evidence of CNS vasculitis. Under the tentative diagnosis of isolated CNS vasculitis, high-dose prednisolone (60 mg/day) was administered and tapered to 10 mg/day.