High-resolution magnetic resonance imaging findings of basilar artery plaque in a patient with branch atheromatous disease: a case report

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• 作者：Yosuke Miyaji (8)
  Yuichi Kawabata (8)
  Hideto Joki (8)
  Shunsuke Seki (9)
  Kentaro Mori (9)
  Tomoya Kamide (9)
  Akira Tamase (9)
  Motohiro Nomura (9)
  Yoshihisa Kitamura (9)
  Fumiaki Tanaka (10)
  
  8. Department of Neurology and Stroke Medicine ; Yokohama Sakae Kyosai Hospital ; 132 Katsura-cho ; Sakae-ku ; Yokohama ; 247-8581 ; Japan
  9. Department of Neurosurgery and Stroke Medicine ; Yokohama Sakae Kyosai Hospital ; 132 Katsura-cho ; Sakae-ku ; Yokohama ; 247-8581 ; Japan
  10. Department of Neurology and Stroke Medicine ; Yokohama City University Graduate School of Medicine ; 3-9 Fukuura ; Kanazawa-ku ; Yokohama ; 236-0004 ; Japan
  
• 关键词：Basilar artery ; Branch atheromatous disease ; Magnetic resonance imaging ; Paramedian pontine artery ; Progressive motor deficits
• 刊名：Journal of Medical Case Reports
• 出版年：2014
• 出版时间：December 2014
• 年：2014
• 卷：8
• 期：1
• 全文大小：391 KB
• 参考文献：1. Caplan, LR (1989) Intracranial branch atheromatous disease: a neglected, understudied, and underused concept. Neurology 39: pp. 1246-1250 CrossRef
  2. Tatsumi, S, Yamamoto, T (2010) An autopsied case of an apparent pontine branch atheromatous disease. Eur Neurol 63: pp. 184-185 CrossRef
  3. Yamamoto, Y, Ohara, T, Hamanaka, M, Hosomi, A, Tamura, A, Akiguchi, I (2011) Characteristics of intracranial branch atheromatous disease and its association with progressive motor deficits. J Neurol Sci 304: pp. 78-82 CrossRef
  4. Chung, JW, Kim, BJ, Sohn, CH, Yoon, BW, Lee, SH (2012) Branch atheromatous plaque: a major cause of lacunar infarction (high-resolution MRI study). Cerebrovasc Dis Extra 2: pp. 36-44 CrossRef
  
• 刊物主题：Medicine/Public Health, general; General Practice / Family Medicine; Public Health; Primary Care Medicine;
• 出版者：BioMed Central
• ISSN：1752-1947

文摘

Introduction Intracranial branch atheromatous disease is a type of ischemic stroke that is caused by narrowing or occlusion of the orifice of the penetrating artery by atheromatous plaque. Pontine branch atheromatous disease is usually diagnosed using indirect findings such as the extension of a lesion to the basal surface of the pons because of the difficulty of demonstrating plaque in the basilar artery. Case presentation A 72-year-old Japanese man developed sudden dysarthria and left hemiparesis, and his symptoms deteriorated thereafter. Brain magnetic resonance imaging revealed an acute infarction in the territory of the right paramedian pontine artery extending to the basal surface. Non-contrast-enhanced three-dimensional fast spin-echo T1 imaging with variable flip angles and three-dimensional fast imaging with steady-state acquisition revealed a plaque in the dorsal wall of the basilar artery that spread to the origin of the paramedian pontine artery that branched toward the infarction. Although antithrombotic agents were started, the left hemiparesis got worse and became flaccid on the following day. Conclusions This is the first report to confirm the pathological basis of branch atheromatous disease by three-dimensional images using the new modalities of 3-Tesla magnetic resonance imaging. The use of these techniques will foster better understanding of the clinicopathological mechanisms of branch atheromatous disease.