[Cerebral vascular autoregulatory dysfunction. Neuroradiologic aspects].
OBJECTIVE
We report the neuroimaging findings in a group of systemic disorders with a common pathophysiological pattern of derangements in cerebral vascular autoregulatory mechanism producting potentially reversible brain lesions.


METHODS
We reviewed the brain CT and MR examinations of 14 patients with clinical diagnosis of vasculopathy not related to atherosclerosis or cardiogenic embolism. The patients were admitted at the onset of neurologic deficit and were affected with one of the following systemic disorders: thrombotic thrombocytopenic purpura (TTP, 6 cases), uremic encephalopathy (4 cases), eclampsia (2 cases), 1 chronic renal failure from systemic lupus erythematosus and 1 cyclosporin neurotoxicity. All patients underwent neuroimaging follow-up within 7-20 days of the onset of neurologic deficit and the start of anti-edema therapy.


RESULTS
CT and MR findings were characterized by cortical-subcortical or deep brain lesions related to edema. Ten patients presented bilateral lesions, which were symmetric in 4 cases. Edema resolution was demonstrated on follow-up examinations after therapy in 4 patients (2 with eclampsia, 1 with TTP and 1 with uremic encephalopathy). The lesions showed no signs of regression in 10 patients.


CONCLUSIONS
Brain lesions with a common pathogenesis from derangements in vascular autoregulatory mechanism--i.e., not due to atherosclerosis or cardiogenic embolism--should be properly and promptly recognized because they can be reversible and readily treatable.
Istituto di Radiologia P. Cignolini, Università degli Studi, Palermo. sparacia@unipa.it
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Sparacia
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Nicastro
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Brancatelli
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Banco
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Lagalla
D000328:Adult; D000368:Aged; D002561:Cerebrovascular Disorders / Q000150:complications / Q000000981:diagnostic imaging* / Q000473:pathology*; D005260:Female; D006801:Humans; D019586:Intracranial Hypertension / Q000150:complications / Q000000981:diagnostic imaging / Q000473:pathology*; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D014057:Tomography, X-Ray Computed
Encefalopatia da disreattività vasoregolatoria cerebrale. Aspetti neuroradiologici.