CNS vasculitis

Findings:

MIP reconstructions from CTA head demonstrate irregular multifocal high-grade stenosis of the left anterior cerebral artery A2 segment. There is also luminal irregularity of additional distal MCA and ACA branches.

Differential Diagnosis/Discussion:

Multifocal intracranial stenosis has a broad differential diagnosis that depends on age of the patient and clinical features. The differential diagnosis for multifocal vascular narrowing includes vasculitis, atherosclerotic disease, vasospasm, and recanalizing emboli. Atherosclerotic disease is by far the most common. Vasospasm would be unusual in the absence of previous subarachnoid hemorrhage or meningitis, alrhough meningitis can cause a combined picture of spasm and inflammatory vasculitis.

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