PMC9871524_01
(1) Flair (A) and diffusion (B) sequences showing recent ischemic capsulo-lenticular involvement and 3DTOF sequence in axial plane (C) and VR reconstruction (D), showing an almost complete absence of internal carotid flow throughout its height. (2) Flair (A) and diffusion (B) sequences showing an extension of ischemia in deep Sylvian territory and enhanced FatSat T1 sequence (C, D), showing enhancement of a circumferential parietal thickening of the right internal carotid artery, extending on the proximal portion of the right Sylvian artery
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MRI (realized 7 h after the beginning of the symptoms) in addition to cerebral and cervical MRA were performed and showed an ischemic stroke of deep territory of right Sylvian artery with almost complete interruption of flow within the internal carotid artery (Figure 1.1). MRI T1 weighted sequence showed a thickening of the wall of the internal carotid artery in its intracranial portion associated with as significate increase of blood flow at this level (Figure 1.2).
(1) T1 FatSat sequence showing circumferential thickening of the intracranial portion of the internal carotid artery and ASL sequence showing increased blood flow in the wall of the internal carotid artery in the intrapetrous portion (B) and in the intracavernous portion (C). (2) 3DTOF axial slice (A) and VR reconstruction (B) showing recanalization of the right internal carotid artery, but with decreased caliper relative to the controlateral artery
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It showed an extension of ischemia in the right deep sylvian territory, and signs of vasculitis on intracranial portion of the right internal carotid and proximal portion of right Sylvian artery (Figure 2.1). Note the partial recanalization of the right internal carotid on this exam (Figure 2.2).