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HVS on FLAIR was seen in 10% of the patients with acute stroke. HVS was associated with large vessel occlusion or severe stenosis (>90%). Intravascular enhancement on contrast MRI was observed in vessels that were hyperintense on FLAIR. Both cortical and subcortical infarcts demonstrated HVS. MR angiographic and cerebral angiographic findings of large vessel occlusion or severe stenosis (>90%), slow flow, low velocities by transcranial Doppler, and hypoperfusion on SPECT correlated with HVS. HVS was the earliest ischemic change in three patients scanned within 3 hours of ictus. Final infarct size was smaller than the area showing HVS in all patients. HVS on FLAIR MRI is an indicator of slow flow and early ischemia as a result of large vessel occlusion or stenosis and inadequacy of collateral circulation. HVS does not mean that infarction has occurred but indicates brain tissue at risk of infarction. It should prompt consideration of revascularization and flow augmentation strategies. |
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carotid artery disease
carotid artery occlusion,neck
carotid artery stenosis
CAT scan,dense artery sign
cerebral arteries
cerebral ischemia
cerebral vasculature
cerebrovascular accident
hyperintense vessel sign
MRI
MRI,abnormal
MRI,contrast enhanced
MRI,early changes in CVA
MRI,FLAIR
MRI,FLAIR,hyperintense vessels
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