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Black blood vessel wall MRI to identify vulnerable atherosclerotic plaque in a non-stenotic intracranial vertebral artery as a cause of acute ischaemia
Author(s) -
Sundip D Udani,
Pervinder Bhogal
Publication year - 2020
Publication title -
bjr case reports
Language(s) - English
Resource type - Journals
ISSN - 2055-7159
DOI - 10.1259/bjrcr.20200061
Subject(s) - icad , medicine , stenosis , vulnerable plaque , stroke (engine) , vertebral artery , cardiology , radiology , coronary artery disease , acute stroke , neuroimaging , artery , mechanical engineering , biochemistry , chemistry , psychiatry , tissue plasminogen activator , engineering , gene
Conventional neuroimaging techniques for investigating the cause of stroke are mainly centred on investigating luminal stenosis. The pathophysiology of intracranial atherosclerotic disease (ICAD) and stroke is complex and extends beyond just vessel narrowing. The concept of the vulnerable atherosclerotic plaque, that can result in acute coronary syndromes, has been well described in the cardiac literature 1,2 although this concept is less well accepted among stroke physicians. We describe a case of a 61-year-old male with acute neurological sequelae from a non-stenotic atherosclerotic plaque of the intracranial vertebral artery. This case report describes the additional use of vessel wall MRI techniques to aid the radiologist in identifying such vulnerable lesions and therefore helping to tailor management and prevent further clinical deterioration.