title: Medullary streaks in a patient with atherosclerotic internal carotid artery occlusion: case report.
abstract: BACKGROUND
  Magnetic resonance imaging (MRI) of a patient with atherosclerotic internal carotid artery (ICA) occlusion demonstrated medullary streaks in the deep white matter, which were previously observed only in moyamoya disease and may indicate decreased cerebral blood flow. Cerebral perfusion and metabolism were evaluated using positron emission tomography (PET).
  
  
  METHODS
  A 46-year-old man presented with right hemiparesis and motor aphasia. Cerebral angiography showed left cervical ICA occlusion. MRI showed medullary streaks in the deep white matter of the left middle cerebral artery (MCA) territory. PET imaging of this region revealed decreased cerebral blood flow and increased oxygen extraction fraction and cerebral blood volume. MRI after superficial temporal artery-MCA anastomosis revealed decreased intensity of the medullary streaks.
  
  
  CONCLUSIONS
  Medullary streaks in patients with atherosclerotic ICA occlusion may indicate reduced perfusion pressure and increased risk of recurrent stroke.
authors.affiliation: Department of Neurosurgery, Iwate Medical University School of Medicine, Morioka, Iwate, Japan.
authors.forename: Chiaki
authors.initials: C
authors.lastname: Mikami
authors.forename: Takashi
authors.initials: T
authors.lastname: Inoue
authors.forename: Kuniaki
authors.initials: K
authors.lastname: Ogasawara
authors.forename: Akira
authors.initials: A
authors.lastname: Ogawa
mesh_terms: D002343:Carotid Artery, Internal / Q000000981:diagnostic imaging / Q000473:pathology*; D016893:Carotid Stenosis / Q000000981:diagnostic imaging / Q000209:etiology / Q000473:pathology*; D006801:Humans; D002537:Intracranial Arteriosclerosis / Q000150:complications / Q000000981:diagnostic imaging / Q000473:pathology*; D008279:Magnetic Resonance Imaging; D008297:Male; D008526:Medulla Oblongata / Q000000981:diagnostic imaging / Q000473:pathology*; D008875:Middle Aged; D014055:Tomography, Emission-Computed