Department of Neurosurgery, Yamaguchi University School of Medicine, 1-1-1, Minamikogushi, Ube, Yamaguchi, Yamaguchi, 755-8505, Japan.
Department of Pediatrics, Yamaguchi University Graduate School of Medicine, Yamaguchi, Japan.
BMC Neurol. 2023 Jul 24;23(1):277. doi: 10.1186/s12883-023-03334-z.
Focal cerebral arteriopathy (FCA) is a clinically important disease that often causes progressive arteriopathy. We report a case of FCA with progressive arteriopathy due to arterial shrinkage of the outer diameter found on T2-weighted three-dimensional sampling perfection with application optimized contrasts using different flip angle evolutions (3D-SPACE) imaging.
The patient was a 9-year-old girl who developed right hemiparesis. Acute infarction was detected in the basal ganglia. Vascular images revealed stenosis from the distal internal carotid artery (ICA) to the middle cerebral artery (MCA). Intravenous heparin was administered for 8 days, and the symptoms improved. However, 29 days after onset, right hemiparesis transiently developed again and magnetic resonance angiography (MRA) showed progressive stenosis from the ICA to MCA, while 3D-SPACE showed similar shrinkage of the outer diameter. Aspirin was started, and there was no subsequent recurrence. After 12 months, MRA and 3D-SPACE showed improvement of stenosis and arterial shrinkage.
Given the time course, the change in the outer diameter was thought to be vasospasm. Thus, vasospasm may be one of the causes of progressive arteriopathy in FCA.
局灶性脑动脉病（FCA）是一种临床重要的疾病，常导致进行性动脉病变。我们报告了一例 FCA 病例，其进行性动脉病变是由于 T2 加权三维采样完美应用优化对比（3D-SPACE）成像发现外径动脉收缩所致。
患者为 9 岁女孩，出现右侧偏瘫。基底节区发现急性梗死。血管图像显示从颈内动脉（ICA）远端到大脑中动脉（MCA）狭窄。给予静脉肝素治疗 8 天，症状改善。然而，发病后 29 天，右侧偏瘫再次短暂发作，磁共振血管造影（MRA）显示从 ICA 到 MCA 的进行性狭窄，而 3D-SPACE 显示外径相似的收缩。开始使用阿司匹林，此后无复发。12 个月后，MRA 和 3D-SPACE 显示狭窄和动脉收缩改善。
鉴于发病时间，外径变化被认为是血管痉挛。因此，血管痉挛可能是 FCA 进行性动脉病变的原因之一。
