title: Eccentric narrowing and enhancement of symptomatic middle cerebral artery stenoses in patients with recent ischemic stroke.
abstract: OBJECTIVE
  To characterize the vessel wall imaging findings and enhancement patterns in the middle cerebral artery of patients with presumed atherosclerotic disease and recent infarction in the territory of the affected artery.
  
  
  METHODS
  Case series.
  
  
  METHODS
  University hospital.
  
  
  METHODS
  We included patients with (1) 2 or more risk factors for atherosclerotic disease; (2) middle cerebral artery stenosis shown on computed tomography, magnetic resonance, or conventional angiography; and (3) recent infarction in the territory of the affected artery.
  
  
  METHODS
  3-T contrast-enhanced high-resolution magnetic resonance imaging.
  
  
  RESULTS
  Eight patients were identified: 6 had an eccentric M1 stenosis, 1 had an eccentric proximal M2 stenosis, and 1 had a distal M2 stenosis with inconclusive eccentricity. Enhancement of the lesion was observed in all patients who underwent scanning within 5 months of the index event. Four intracranial atherosclerotic plaques were found in asymptomatic vessels (1 contralateral middle cerebral artery and 3 other intracranial arteries), and none of these had enhancement.
  
  
  CONCLUSIONS
  Patients with presumed intracranial atherosclerosis of the middle cerebral arteries have eccentric plaques that enhance after the administration of contrast medium when imaging is performed within weeks to months of a cerebral infarct within the arterial territory.
authors.affiliation: Division of Neurology, Department of Medicine, Toronto Western Hospital, and University of Toronto, 2075 Bayview Ave, Room A442, Toronto, ON M4N 3M5, Canada.
authors.forename: Mervyn D I
authors.initials: MD
authors.lastname: Vergouwen
authors.forename: Frank L
authors.initials: FL
authors.lastname: Silver
authors.forename: Daniel M
authors.initials: DM
authors.lastname: Mandell
authors.forename: David J
authors.initials: DJ
authors.lastname: Mikulis
authors.forename: Richard H
authors.initials: RH
authors.lastname: Swartz
mesh_terms: D000368:Aged; D001778:Blood Coagulation Disorders / Q000150:complications; D002545:Brain Ischemia / Q000473:pathology*; D002533:Cerebral Angiography; D003251:Constriction, Pathologic; D003324:Coronary Artery Disease / Q000150:complications; D005260:Female; D006801:Humans; D006949:Hyperlipidemias / Q000150:complications; D020244:Infarction, Middle Cerebral Artery / Q000473:pathology; D002537:Intracranial Arteriosclerosis / Q000473:pathology; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D020768:Middle Cerebral Artery / Q000473:pathology*; D012307:Risk Factors; D012907:Smoking; D020521:Stroke / Q000473:pathology*; D014057:Tomography, X-Ray Computed