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Plaque Characterization Using Carotid MRI in Acute Ischemic Cerebrovascular Syndromes (Three Case Reports) : Can Carotid MRI be Useful as an Adjunct to the Diagnosis of TIA in which the Ischemic Lesions were Recognized at a Later Date? Hideki Endo 1 , Kazumichi Yoshida 1 , Takeshi Funaki 2 , Kenichi Kono 1 , Nobutake Sadamasa 1 , Osamu Narumi 1 , Masaki Chin 1 , Sen Yamagata 1 1Department of Neurosurgery,Kurashiki Central Hospital 2Department of Neurosurgery,National Cardiovascular Center Keyword: transient ischemic attack , diffusion-weighted image , carotid MRI , vulnerable plaque pp.1191-1195
Published Date 2008/10/1
DOI https://doi.org/10.11477/mf.1416100364
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Abstract

 Recent diffusion-weighted imaging (DWI) studies describe a relevant ischemic lesion in almost half of all patients with transient ischemic attack (TIA). We report 3 cases of TIA in which the ischemic lesions were recognized on DWI at a later date ("late-imaged TIA"). Three men (average age,72.7 years) were admitted to our hospital on complains of monoparesis or sensory disturbance in their right arms. On admission,no apparent ischemic lesion was detected by DWI; however,spotty lesions were apparent in the left precentral or postcentral gyrus on hospital days 2-5. The neurological symptoms resolved within 24 hours,and all the cases were clinically diagnosed as TIA. Carotid MRI revealed low-grade stenosis of the left internal carotid artery with atherosclerotic plaque,characterized as so-called "vulnerable plaque". These findings suggest that the carotid atherosclerotic plaque lead to artery-to-artery embolism. Carotid MRI is considered useful as an adjunct to other imaging modalities in the diagnosis of late-imaged TIA.

(Received: February 25,2008,Accepted: July 11,2008)


Copyright © 2008, Igaku-Shoin Ltd. All rights reserved.

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電子版ISSN 1344-8129 印刷版ISSN 1881-6096 医学書院

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