Primary angiitis of the central nervous system
Young boy with headache, mental status change and right sided weakness.
Loading Stack -
0 images remaining
Left basal ganglia few (about three) foci of abnormal signal intensity are seen demonstrating hypointense T1 / FLAIR and hyperintense T2 signal with perifocal gliosis.
MR angiography shows attenuated cervical petrous, cavernous and supraclinoid portions of the left ICA with mural irregularity. Attenuated A1 segment of the left ACA as well as M1 and proximal M2 segments of the left MCA with mural irregularity and beaded appearance. Normal caliber and signal intensity of the right ICA as well as the right ACA and MCA. Attenuated left vertebral artery otherwise, normal vertebro-basilar system as well as normal both posterior cerebral arteries. No evidence of aneurysmal dilatation or AVM.
MR venography shows no evidence of venous sinus thrombosis; normal deep and cortical veins.
The above described findings are suggestive for CNS vasculitis, mostly primary CNS angiitis, as well as left basal ganglia lacunar infarction with developing encephalomalacia.