Hyperintense vessels on flair imaging in reversible cerebral vasoconstriction syndrome

Shih Pin Chen, Jong Ling Fuh, Jiing Feng Lirng, Shuu Jiun Wang*

*Corresponding author for this work

Research output: Contribution to journalReview articlepeer-review

38 Scopus citations

Abstract

Objectives: To study the frequency and significance of distal hyperintense vessels (HVs) on fluid-attenuated inversion recovery (FLAIR) imaging in patients with reversible cerebral vasoconstriction syndrome (RCVS). Methods: Patients with RCVS were recruited during 2002 through 2009. Prominence and location of HVs on FLAIR images during the acute and recovery stages were documented. Clinical profiles, vasoconstriction scores, mean flow velocities of the middle cerebral artery (V MCA) and posterior cerebral artery (V PCA), and the Lindegaard index (LI) were collected for analysis. Results: Ninety-five patients with RCVS (11M/84F, mean age 47.8 ± 10.9 years) were recruited. Twenty-one (22.1%) had FLAIR HVs, which were noted at a mean of 14.3 ± 12.7 days and resolved by 44.9 ± 18.8 days. Compared with patients without HVs, patients with this finding had higher vasoconstriction scores for all arterial segments; higher V MCA (121.0 ± 39.5 cm/s vs. 93.3 ± 27.8, p = 0.002), V PCA (73.3 ± 35.0 vs. 50.5 ± 17.8 cm/s, p = 0.010), and LI (2.8 ± 1.2 vs. 1.9 ± 0.5, p = 0.018), and complications such as posterior reversible encephalopathy syndrome (PRES) [8/21 (38%) vs. 0/74 (0%), p < 0.001] or ischemic stroke [5/21 (24%) vs. 1/74 (1%), p = 0.002]. Conclusions: HVs in patients with RCVS might be attributed to the failure of cerebrospinal fluid (CSF) signal nulling on FLAIR imaging due to severe cerebral hemodynamic derangements and were associated with more frequent ischemic complications.

Original languageEnglish
Pages (from-to)271-278
Number of pages8
JournalCephalalgia
Volume32
Issue number4
DOIs
StatePublished - Mar 2012

Keywords

  • fluid attenuated inversion recovery (FLAIR)
  • hyperintense vessels
  • magnetic resonance imaging
  • Reversible cerebral vasoconstriction syndrome

Fingerprint

Dive into the research topics of 'Hyperintense vessels on flair imaging in reversible cerebral vasoconstriction syndrome'. Together they form a unique fingerprint.

Cite this