|
An 84 year-old man presented with a left visual field defect and change in personality. |
| Intracranial Disease:
(Top) Flair axial MRIs; (Bottom) Magnetic
Resonance Angiography (MRA), intracranial circulation. In the brain images on the top,
note the areas of increased signal in the right occipital lobe in the territory of the
right posterior cerebral artery (PCA) and the right temporal lobe in the
distribution of the inferior division of the right middle cerebral artery
(MCA). On the MRA images on the bottom, note that the right PCA is occluded (bottom right) and the right
MCA is severely narrowed or occluded (bottom left). Note that some flow is seen distally
in the right MCA,
indicating that either the lesion is severely stenotic (but not
occluded) or there is intact collateral
circulation.
This patient has primary disease of the intracranial circulation. Atherosclerosis affecting the MCA, anterior cerebral artery (ACA) and posterior cerebral artery (PCA) is more common in certain racial and ethnic groups. This pattern is more common in people of African American and Asian descent, compared with Caucasians in whom atherosclerosis is often more prominent in the carotid and proximal vertebral arteries. |
Revised
11/29/06
Copyrighted 2006. David C Preston