Article PDF first page preview

First page of Focal cerebral arteriopathy of the young: clinical profile, outcomes and utility of high-resolution vessel wall imaging

Background: The data on focal cerebral arteriopathy (FCA) in young adults is limited to very few series and the role of high-resolution Magnetic resonance vessel wall imaging (MRVWI) has not been adequately explored. Methods: FCA was defined as unilateral, unifocal non progressive stenosis/irregularity of the distal internal carotid artery (ICA) or its proximal branches. All young patients aged 18-55 years admitted to our institute between 2010-2022 were retrospectively reviewed and functional outcomes were quantified using modified Rankin scale (mRS). Results: We identified 10 patients (9 males) with FCA giving an incidence rate of 2.8 per 1000 patient years. Nine patients had an ischemic presentation (transient ischemic attacks=5, minor strokes=3 and major stroke=1) while one patient had a cortical subarachnoid hemorrhage. The supraclinoid ICA and proximal middle cerebral artery (MCA) were the most common segments involved. Nine patients were treated with antiplatelets and 3 received additional steroids. All cases underwent MRVWI with concentric wall enhancement noted in most (80%). Follow-up imaging showed improvement in stenosis in two patients, reduction in vessel wall enhancement in three patients. Except for the patient with major stroke, all others had excellent short and long-term outcomes with no recurrence of ischemic events. The presence of vessel wall enhancement did not predict short or long-term outcomes. Conclusion: FCA is a rare cause of young stroke that preferentially involves the supraclinoid ICA and proximal MCA with excellent outcomes. MRVWI can be useful in ruling out mimics, but the presence of contrast enhancement did not predict outcome.

Journal Section:
Clinical Research in Stroke
This content is only available via PDF.
The Author(s). Published by S. Karger AG, Basel
Open Access License / Drug Dosage / Disclaimer
This article is licensed under the Creative Commons Attribution-NonCommercial 4.0 International License (CC BY-NC). Usage and distribution for commercial purposes requires written permission.
Drug Dosage: The authors and the publisher have exerted every effort to ensure that drug selection and dosage set forth in this text are in accord with current recommendations and practice at the time of publication. However, in view of ongoing research, changes in government regulations, and the constant flow of information relating to drug therapy and drug reactions, the reader is urged to check the package insert for each drug for any changes in indications and dosage and for added warnings and precautions. This is particularly important when the recommended agent is a new and/or infrequently employed drug.
Disclaimer: The statements, opinions and data contained in this publication are solely those of the individual authors and contributors and not of the publishers and the editor(s). The appearance of advertisements or/and product references in the publication is not a warranty, endorsement, or approval of the products or services advertised or of their effectiveness, quality or safety. The publisher and the editor(s) disclaim responsibility for any injury to persons or property resulting from any ideas, methods, instructions or products referred to in the content or advertisements.
2025
This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License .
Attribution-NonCommercial