Advanced

AJNR - American Journal of Neuroradiology

This Article Abstract Full Text Full Text (PDF) Alert me when this article is cited Alert me if a correction is posted Services Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Download to citation manager Citing Articles Citing Articles via CrossRef Citing Articles via Google Scholar Google Scholar Articles by Lowe, L. H. Articles by Lasky, A. Search for Related Content PubMed PubMed Citation Articles by Lowe, L. H. Articles by Lasky, A.

Application of Transcranial Doppler Sonography in Children with Acute Neurologic Events due to Primary Cerebral and West Nile Vasculitis

Lisa H. Lowe^a, Frank P. Morello^a, Mary A. Jackson^b and Andrew Lasky^c

^a Department of Radiology, Children’s Mercy Hospitals & Clinics, University of Missouri-Kansas City, 2401 Gillham Road, Kansas City, MO 64108
^b Department of Infectious Diseases, Children’s Mercy Hospitals & Clinics, University of Missouri-Kansas City, 2401 Gillham Road, Kansas City, MO 64108
^c Department of Rheumatology, Children’s Mercy Hospitals & Clinics, University of Missouri-Kansas City, 2401 Gillham Road, Kansas City, MO 64108

View larger version (82K): [in a new window]   FIG 1. Primary cerebral vasculitis in a 7-year-old girl. PSV indicates peak systolic velocity; MCA, middle cerebral artery; ICA, internal carotid artery, ACA, anterior cerebral artery. (A) Graph of transcranial Doppler sonography results plotted for 28 months show gradual improvement in all left-sided vessels. Note variation of individual measurements compared with trends over time. (B) Transcranial Doppler sonography spectrum shows elevated peak systolic velocities in the left MCA. (C) MR angiogram reveals decreased caliber of slightly irregular distal left ICA, A1 segment of the ACA, and M1 of the MCA (arrow). (D) Catheter angiogram obtained 2 days after initiation of therapy demonstrates slight narrowing and irregularity of the distal ICA (arrows). (E) Twenty-eight-month follow-up transcranial Doppler sonogram and (F) catheter angiogram show that the PSV and anatomical appearance of the vessels have returned to near normal.

View larger version (12K): [in a new window]   FIG 2. Primary cerebral vasculitis in a 12-year-old girl. Graph of transcranial Doppler sonography results plotted for 14 months demonstrates some improvement in the left internal carotid artery (ICA) and anterior cerebral artery (ACA) but persistent disease in the left middle cerebral artery (MCA).

View larger version (15K): [in a new window]   FIG 3. West Nile vasculitis in a 9-year-old girl. MCA indicates middle cerebral artery; ICA, internal carotid artery, ACA, anterior cerebral artery. (A) Graph of transcranial Doppler sonography results plotted for 8 months reveal persistence of elevated peak systolic velocity in the left MCA, ACA, and ICA. (B) MR angiogram reveals decreased caliber and irregularity of the left MCA with slight narrowing of the supraclinoid ICA and A1 segment of the ACA (arrows).