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Unilateral Supraclinoid Internal Carotid Artery Stenosis with Moyamoya‐like Vasculopathy: Noninvasive Assessments
Author(s) -
Muppala Murali,
Castaldo John E
Publication year - 1994
Publication title -
journal of neuroimaging
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.822
H-Index - 64
eISSN - 1552-6569
pISSN - 1051-2284
DOI - 10.1111/jon19944111
Subject(s) - medicine , internal carotid artery , transcranial doppler , radiology , magnetic resonance imaging , stenosis , middle cerebral artery , ophthalmic artery , cardiology , ischemia , blood flow
Presented are the results of an extensive noninvasive assessment of supraclinoid internal carotid artery (ICA) stenosis with moyamoya‐like vasculopathy in 3 patients with a history of stroke. Five noninvasive criteria for the diagnosis based on magnetic resonance imaging of the brain, and hemodynamic testing using ocular pneumoplethysmography, duplex carotid ultrasound, and transcranial Doppler sonography were established: (1) normal ocular pneumoplethysmography demonstrating no pressure significant stenosis to the level of the ophthalmic artery; (2) abnormal Doppler spectral waveforms showing either no flow or a high‐resistance flow pattern for the ipsilateral cervical internal carotid artery; (3) paradoxically low flow velocities for the ipsilateral intracranial (ICA) and middle cerebral artery (MCA), and markedly abnormal high velocities for the contralateral ICA and MCA; (4) decreased ipsilateral MCA vasomotor reactivity; and (5) deep MCA territory ipsilateral subcortical watershed infarction evidenced by magnetic resonance imaging. This report demonstrates that a noninvasive battery of tests may be useful in the early diagnosis and treatment of these patients.