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Teaching NeuroImages: Giant cell arteritis presenting with acute ischemic strokes due to diffuse intracranial stenoses
A 72-year-old woman with unremarkable medical history was admitted with acute ischemic strokes (AIS) in multiple arterial distributions in anterior and posterior circulation (figure 1A and supplemental data at Neurology.org). Elevated erythrocyte sedimentation rate (98 mm/h) prompted the evaluation of superficial temporal arteries (STA) with duplex sonography (halo sign; figure 1B) and contrast angiography (right STA [figure 2A] and multiple intracranial arterial stenoses [figure 2, A–D]). STA biopsy confirmed the diagnosis of giant cell arteritis (GCA; figure 1, C and D).
Source: Neurology - October 9, 2017 Category: Neurology Authors: Kargiotis, O., Safouris, A., Petrou, V. N., Magoufis, G., Stamboulis, E., Tsivgoulis, G. Tags: MRI, Ultrasound, Vasculitis, All Cerebrovascular disease/Stroke RESIDENT AND FELLOW SECTION Source Type: research

Teaching NeuroImages: Takayasu arteritis: Neuroimaging progression after immunosuppressant treatment
A 29-year-old woman presented with a 2-year history of heel pain, constitutional symptoms, and increased acute phase reactants. CT and magnetic resonance (MR) angiography revealed a thickening of aortic walls and a thread-like appearance of bilateral subclavian and common carotid arteries. The findings were consistent with Takayasu arteritis (TA)1 and the patient was prescribed methylprednisolone, followed by azathioprine. Follow-up MR angiography, 6 years later, showed an important improvement with only a mild luminal narrowing of both common carotid arteries (figures 1 and 2, A and B). TA is a large-artery inflammatory d...
Source: Neurology - May 15, 2017 Category: Neurology Authors: Martinez Rodriguez, L., Caminal Montero, L., Pena Suarez, J., Garcia-Cabo Fernandez, C., Calleja Puerta, S. Tags: MRI, Vasculitis, All Cerebrovascular disease/Stroke RESIDENT AND FELLOW SECTION Source Type: research

Teaching NeuroImages: HIV-associated cerebral vasculopathy with multiple nodular aneurysms
HIV-associated cerebral vasculopathy with multiple aneurysms has been widely reported in children1 and has to be considered in HIV-infected patients with high CSF viral load, but only few cases in adults have been published so far. Nodular and fusiform aneurysms (figure, A–D) are a typical imaging finding2 that may lead to suspicion of an autoimmune etiology by mimicking polyarteritis nodosa. These aneurysms might carry clinical significance with regard to the risk of subarachnoid or intracerebral hemorrhage, or causing infarction through formation of emboli. Highly active antiretroviral therapy leads to remission of...
Source: Neurology - April 3, 2017 Category: Neurology Authors: Seiler, A., You, S.-J., Wagner, M., Klein, J. C. Tags: Stroke in young adults, All Imaging, Vasculitis, HIV, All Cerebrovascular disease/Stroke RESIDENT AND FELLOW SECTION Source Type: research

French Intensive Care Society, International congress - Réanimation 2016.
C, Sauneuf B, Verrier P, Pottier V, Orabona M, Samba D, Viquesnel G, Lermuzeaux M, Hazera P, Hanouz JL, Parienti JJ, Du Cheyron D, Demoule A, Clavel M, Rolland-Debord C, Perbet S, Terzi N, Kouatchet A, Wallet F, Roze H, Vargas F, Guérin C, Dellamonica J, Jaber S, Similowski T, Quenot JP, Binquet C, Vinsonneau C, Barbar SD, Vinault S, Deckert V, Lemaire S, Hssain AA, Bruyère R, Souweine B, Lagrost L, Adrie C, Jung B, Daurat A, De Jong A, Chanques G, Mahul M, Monnin M, Molinari N, Lheureux O, Trepo E, Hites M, Cotton F, Wolff F, Surin R, Créteur J, Vincent JL, Gustot T, Jacobs F, Taccone FS, Neuville M, Timsit JF, El-Hel...
Source: Australian Family Physician - May 31, 2016 Category: Primary Care Authors: Jaillette E, Girault C, Brunin G, Zerimech F, Chiche A, Broucqsault-Dedrie C, Fayolle C, Minacori F, Alves I, Barrailler S, Robriquet L, Delaporte E, Thellier D, Delcourte C, Duhamel A, Nseir S, Valette X, Desmeulles I, Savary B, Masson R, Seguin A, Daubi Tags: Ann Intensive Care Source Type: research

Challenge of Identifying the Cause of Intracranial Artery Stenosis in Patients With Ischemic Stroke Illustrative Teaching Case
Source: Stroke - February 23, 2015 Category: Neurology Authors: Lanthier, S., Odier, C., Sundararajan, S., Strbian, D. Tags: Secondary prevention, Other arteriosclerosis, Other diagnostic testing, Stroke in Children and the Young, Vasculitis Brain Arteries Illustrative Teaching Case Source Type: research

Teaching NeuroImages: Macaroni sign
A 35-year-old patient with previously diagnosed and currently untreated Takayasu arteritis presented with motor aphasia. The symptom had started 24 hours before presentation and ceased after another 12 hours. Cranial MRI and magnetic resonance angiography were normal. Plasma concentration of C-reactive protein was elevated (9.1 mg/dL). Duplex ultrasonography showed hypoechoic, homogeneous thickening of the intima–media complex of the left common carotid artery (figure). This finding, also referred to as "macaroni sign," has been reported in Takayasu arteritis.1,2 The patient was transferred to the rheumatologic depar...
Source: Neurology - June 30, 2014 Category: Neurology Authors: Siepmann, T., Bodechtel, U. Tags: Ultrasound, Autoimmune diseases, Vasculitis, All Cerebrovascular disease/Stroke RESIDENT AND FELLOW SECTION Source Type: research