title: Hyperintense vessels on flair imaging in reversible cerebral vasoconstriction syndrome.
abstract: OBJECTIVE
  To study the frequency and significance of distal hyperintense vessels (HVs) on fluid-attenuated inversion recovery (FLAIR) imaging in patients with reversible cerebral vasoconstriction syndrome (RCVS).
  
  
  METHODS
  Patients with RCVS were recruited during 2002 through 2009. Prominence and location of HVs on FLAIR images during the acute and recovery stages were documented. Clinical profiles, vasoconstriction scores, mean flow velocities of the middle cerebral artery (V(MCA)) and posterior cerebral artery (V(PCA)), and the Lindegaard index (LI) were collected for analysis.
  
  
  RESULTS
  Ninety-five patients with RCVS (11M/84F, mean age 47.8 ± 10.9 years) were recruited. Twenty-one (22.1%) had FLAIR HVs, which were noted at a mean of 14.3 ± 12.7 days and resolved by 44.9 ± 18.8 days. Compared with patients without HVs, patients with this finding had higher vasoconstriction scores for all arterial segments; higher V(MCA) (121.0 ± 39.5 cm/s vs. 93.3 ± 27.8, p = 0.002), V(PCA) (73.3 ± 35.0 vs. 50.5 ± 17.8 cm/s, p = 0.010), and LI (2.8 ± 1.2 vs. 1.9 ± 0.5, p = 0.018), and complications such as posterior reversible encephalopathy syndrome (PRES) [8/21 (38%) vs. 0/74 (0%), p < 0.001] or ischemic stroke [5/21 (24%) vs. 1/74 (1%), p = 0.002].
  
  
  CONCLUSIONS
  HVs in patients with RCVS might be attributed to the failure of cerebrospinal fluid (CSF) signal nulling on FLAIR imaging due to severe cerebral hemodynamic derangements and were associated with more frequent ischemic complications.
authors.affiliation: Department of Neurology, Neurological Institute, Taipei Veterans General Hospital, Taipei, Taiwan.
authors.forename: Shih-Pin
authors.initials: SP
authors.lastname: Chen
authors.forename: Jong-Ling
authors.initials: JL
authors.lastname: Fuh
authors.forename: Jiing-Feng
authors.initials: JF
authors.lastname: Lirng
authors.forename: Shuu-Jiun
authors.initials: SJ
authors.lastname: Wang
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D001921:Brain / Q000098:blood supply* / Q000473:pathology / Q000503:physiopathology; D001927:Brain Diseases / Q000473:pathology* / Q000503:physiopathology; D002648:Child; D005260:Female; D006801:Humans; D007090:Image Interpretation, Computer-Assisted; D018810:Magnetic Resonance Angiography; D008279:Magnetic Resonance Imaging / Q000379:methods*; D008297:Male; D008875:Middle Aged; D014661:Vasoconstriction; D055815:Young Adult