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The Cerebral Angiographic Findings in Cogan Syndrome

M. Sait Albayrama, Robert Wityka, David M. Yousema and S. James ZinreichGo,a

a From the Departments of Neuroradiology (M.S.A., D.M.Y., S.J.Z.) and Neurology (R.W.), The Johns Hopkins Medical Intitutions, Baltimore, MD.



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  		FIG 1.A and B, MR images obtained in 1997 after the patient's cerebrovascular accidents in 1996 and 1997. Axial T2-weighted images (4000/100/2) reveal a subacute infarction in the left basal ganglia (asterisk) and a chronic infarction in the posterior right parietal lobe (star)



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  		FIG 2.  Cerebral angiographic images obtained in 1997.

A and B, An anteroposterior projection of the left internal carotid artery (A) and a 20° left posterior oblique projection (B) of the right internal carotid artery also reveal alternating areas of stenosis (arrow) and ectasia (arrowheads). Note stenotic areas in the course of the anterior temporal artery. No evidence of aneurysm was noted in the internal carotid artery distributions.

C and D, Anteroposterior projection (C) and lateral projection (D) of the selected injection of the right vertebral artery show alternating areas of ectasia (arrowheads) and stenosis (arrow) involving the distal segment of the right vertebral artery and the proximal segment of the basilar artery. A small aneurysm (a) is present at the vertebrobasilar junction.



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  		FIG 3. A and B, Selective injections of the internal carotid artery distributions performed in 1999 after immunosuppresant/corticosteroid therapy.

Selected anteroposterior projection of the left internal carotid artery (A) and anteroposterior projection of the selected right internal carotid artery injection (B) show prominent ectasia (arrowheads) within the M1 segment of left MCA. Severe occlusive disease (arrow) is noted within the left MCA distribution. Compared with the angiographic images of 1997, the ectasis in the left M1 segment of the MCA is more prominent as is the stenotic portion of this vessel. The stenosis of the M1 segment of the right MCA has improved (arrow).





Copyright © 2009 by the American Society of Neuroradiology. Print ISSN: 0195-6108 Online ISSN: 1936-959X