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Training Collections
Library Memberships
Black Friday Save 30%On-demand course library with video lectures, expert case reviews, and more
Fellowship Certificate™ Programs
Black Friday Save 30%Practice-focused training programs designed to help you gain experience in a specific subspecialty area.
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Black Friday Save 40%Unlock access to our full Course Library and all self-paced Fellowships.
Noon Conference (Free)
Get access to free live lectures, every week, from top radiologists.
Case of the Week (Free)
Get a free weekly case delivered right to your inbox.
Dr. Resnick's MSK Conference
BLACK FRIDAY SAVE 30%Learn directly from the MSK Master himself.
Lower Extremities MRI Conference
Musculoskeletal Imaging
Emergency Imaging
PET Imaging
Pediatric Imaging
For Training Programs
Supplement your training program with case-based learning for residents, registrars, fellows, and more.
For Private Practices
Upskill in high growth, advanced imaging areas.
Emergency Call Prep
Prepare trainees to be on call for the emergency department with this specialized training series.
1 topic, 3 min.
4 topics, 17 min.
5 topics, 14 min.
10 topics, 33 min.
Vascular Imaging in Stroke - CTA vs MRA
2 m.Carotid and Vertebral Vasculopathies Overview & Examples of Atherosclerotic Disease
3 m.Case - Atheromatous Disease with Severe ICA Stenosis
4 m.Carotid & Vertebral Artery Dissection Overview & Examples
3 m.Case - Embolic Stroke with ICA Dissection
5 m.Collagen Vascular Diseases Overview - Examples of FMD, Carotid Web
2 m.Case - Fibromuscular Dysplasia (FMD)
5 m.Case - Ehlers Danlos
7 m.Inflammatory Conditions with Stroke Symptoms - Examples of Takayasu's, TIPIC
4 m.Case - Takayasu’s Arteritis
4 m.9 topics, 37 min.
CTA Head in Acute Stroke - Source Images, MIPS, Collaterals
4 m.Case - MCA Stem Embolus with Good Collaterals
5 m.Case - MCA Stem Embolus with Poor Collaterals
4 m.Case - Basilar Tip Thrombus
6 m.Circle of Willis Stenoses: Differential Diagnoses
2 m.Case - Moya Moya disease
6 m.Case - Reversible Cerebral Vasoconstrictive Syndrome (RCVS)
5 m.Case - Primary Angiitis of the CNS (PACNS)
7 m.Infectious Causes of Multifocal Circle of Willis Stenosis
2 m.3 topics, 15 min.
3 topics, 14 min.
6 topics, 18 min.
6 topics, 26 min.
6 topics, 16 min.
7 topics, 18 min.
Stroke Mimics - Other Causes of Restricted Diffusion
2 m.Case - Seizure (Stroke Mimic)
4 m.Case - MELAS (Stroke Mimic)
3 m.Case - Hypoglycemia (Stroke Mimic)
3 m.Case - Herpes Virus Encephalitis (Stroke Mimic)
4 m.Case - Osmotic Demyelination Syndrome (Stroke Mimic)
3 m.Case - Brain Metastases (Stroke Mimic)
4 m.8 topics, 17 min.
MR Perfusion - Data, Maps and Uses
4 m.Case - MR Perfusion Target Mismatch (Good Collaterals)
2 m.Case - MR Perfusion Target Mismatch (Poor Collaterals)
3 m.Case - Ischemia Detected Only on MR Perfusion (Case 1)
2 m.Case - Ischemia Detected Only on MR Perfusion (Case 2)
3 m.Arterial Spin Labelling Perfusion - Usage Examples
3 m.Case - ASL Matched Defect
2 m.Case - ASL Showing Tissue at Risk
2 m.5 topics, 13 min.
0:00
I wanted to discuss a couple of other things
0:02
that cause diffuse multifocal narrowings
0:06
in the circle of Willis,
0:07
and one of them is varicella zoster.
0:09
It's seen in patients with decreased cell immunity,
0:13
so HIV organ transplant are very old,
0:16
like 90 year olds.
0:17
It's due to reactivation of the varicella zoster virus
0:21
due to a decrease in cell-mediated immunity.
0:24
Here at these are images of a 30-year-old female
0:26
with HIV, with acute left over extremity
0:29
weakness and facial numbness,
0:30
and she has a border zone infarct between
0:33
ACAs and MCAs,
0:34
and you can see on her coronal MIP image
0:38
that there are multifocal vascular stenosis
0:40
in the MCAs bilaterally,
0:42
and the bilateral ACAs.
0:45
Another cause of multifocal vascular narrowings
0:48
is tuberculosis meningitis.
0:50
You tend to see it in endemic areas,
0:53
especially in kids,
0:54
and what they have is basilar meningitis.
0:57
As you can see in this case,
0:58
this extensive thickening and enhancement
1:01
of the meninges,
1:03
along the basilar cisterns and extending
1:05
into the Sylvian fissures, and you can get
1:07
inflammation in the vessels and cause narrowing
1:10
of the bilateral MCAs and ACAs
1:12
and get multiple infarcts.
1:14
You can see the patient has multiple
1:15
MCA and ACA infarcts bilaterally.
Interactive Transcript
0:00
I wanted to discuss a couple of other things
0:02
that cause diffuse multifocal narrowings
0:06
in the circle of Willis,
0:07
and one of them is varicella zoster.
0:09
It's seen in patients with decreased cell immunity,
0:13
so HIV organ transplant are very old,
0:16
like 90 year olds.
0:17
It's due to reactivation of the varicella zoster virus
0:21
due to a decrease in cell-mediated immunity.
0:24
Here at these are images of a 30-year-old female
0:26
with HIV, with acute left over extremity
0:29
weakness and facial numbness,
0:30
and she has a border zone infarct between
0:33
ACAs and MCAs,
0:34
and you can see on her coronal MIP image
0:38
that there are multifocal vascular stenosis
0:40
in the MCAs bilaterally,
0:42
and the bilateral ACAs.
0:45
Another cause of multifocal vascular narrowings
0:48
is tuberculosis meningitis.
0:50
You tend to see it in endemic areas,
0:53
especially in kids,
0:54
and what they have is basilar meningitis.
0:57
As you can see in this case,
0:58
this extensive thickening and enhancement
1:01
of the meninges,
1:03
along the basilar cisterns and extending
1:05
into the Sylvian fissures, and you can get
1:07
inflammation in the vessels and cause narrowing
1:10
of the bilateral MCAs and ACAs
1:12
and get multiple infarcts.
1:14
You can see the patient has multiple
1:15
MCA and ACA infarcts bilaterally.
Report
Faculty
Pamela W Schaefer, MD, FACR
Professor of Radiology, Vice Chair of Education
Massachusetts General Hospital
Tags
Vascular Imaging
Neuroradiology
Neuro
MRI
Head and Neck
CTA
CT
Brain
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