Case Report: Serial MR Vessel Wall Imaging Visualizes the Response of Intracranial Plaques and Assists in Decision-Making

Jiayu Xiao; Matthew M Padrick; Shlee S Song; Zhaoyang Fan; Konrad H Schlick

doi:10.3389/fnins.2021.739178

Case Report: Serial MR Vessel Wall Imaging Visualizes the Response of Intracranial Plaques and Assists in Decision-Making

Front Neurosci. 2021 Oct 20:15:739178. doi: 10.3389/fnins.2021.739178. eCollection 2021.

Authors

Jiayu Xiao^{1

2}, Matthew M Padrick³, Shlee S Song³, Zhaoyang Fan^{1

2

4}, Konrad H Schlick³

Affiliations

¹ Departments of Radiology, Keck School of Medicine of USC, Los Angeles, CA, United States.
² Biomedical Imaging Research Institute, Department of Biomedical Sciences, Cedars-Sinai Medical Center, Los Angeles, CA, United States.
³ Department of Neurology, Cedars-Sinai Medical Center, Los Angeles, CA, United States.
⁴ Departments of Radiation Oncology, Keck School of Medicine of USC, Los Angeles, CA, United States.

Abstract

Intracranial atherosclerotic disease (ICAD) is a dynamic process that leads to ischemic stroke. Symptomatic ICAD patients still suffer a high recurrent rate even under standard treatment. In this case report, to better understand the response of intracranial atherosclerotic plaques to medication, serial MR imaging was added to standard clinical workup in a 47-year-old male patient with acute occipital lobe infarction at baseline, 3-month, 6-month, and 12-month post index stroke to directly visualize the morphology and signal change of plaques. We noticed that one of the plaques showed dramatic worsening at 3-month imaging follow-up despite a decrease in low-density lipoprotein level. Early identification of patients who do not respond well to medication is critical to prevent the recurrence of cardiovascular events in ICAD patients.

Keywords: follow-up study; intracranial atherosclerosis; plaque; stroke; vessel wall imaging.

Publication types

Case Reports