PMC3299075_01
Axial contrast-enhanced T1-weighted fat saturated image shows thickened enhancing pachymeninges in the right middle cranial fossa and paracavernous region (a-thin arrows). Thickened pachymeninges can also be seen on T2-weighted constructive interference at steady state (CISS) images also (b-thin arrows). Digital subtraction angiography (DSA) of the aortic arch (c) and abdominal aorta (d) shows the left subclavian occlusion (thick arrow) and the non-visualization of the left renal artery with narrowing of the juxta renal abdominal aorta (arrow head), respectively
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F1
Magnetic resonance imaging of the brain revealed abnormal, thickened enhancing pachymeninges in bilateral frontal and right temporal region extending to cavernous sinus [Figures 1 a and b]. DSA revealed stenosis of left subclavian artery distal to the origin of vertebral artery, osteal stenosis of left renal artery, and narrowing of abdominal aorta at the level of the origin of renal arteries with normal terminal aorta and bilateral common iliac arteries [Figure 1 c and d].
Coronal T2-weighted image (a) and axial Fluid Attenuated Inversion Recovery (FLAIR) sequence (b, shows subcortical white matter hyperintensity in right temporal lobe extending in to the overlying cortex
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F2
Inversion Recovery) hyperintensity in right temporal lobe [Figure 2]. In view of feeble left radial pulse and renal bruit, patient underwent conventional digtal subtraction angiography (DSA), for better characterization of the vascular system.