A 54-year-old female had bilateral infarcts in a parasagittal distribution (Figure 1A). Digital subtraction angiography showed a low-grade stenosis at the terminal segment of left internal carotid artery (ICA), with a plaque on high-resolution magnetic resonance imaging (HR-MRI) (Figure 1B,C). Clopidogrel 75 mg/day, atorvastatin 60 mg/day, and amlodipine 5 mg/day were prescribed. Eighty days after the treatments, ICA plaque regression was observed on repeated HR-MRI (Figure 1D). There was no stroke recurrence. Our case suggests HR-MRI has made it possible to quantify intracranial plaque burden and evaluate its progression (1). Intensive medical treatments may play a role in reversing intracranial atherosclerosis, like they do in extracranial atherosclerosis (2).
Figure 1.
Diffusion weighted imaging (A) and angiography (B) showed ischemic infarcts due to left internal carotid artery stenosis with an azygous anterior cerebral artery. On T1-weighted images of high-resolution MRI, a plaque (arrow, C) was identified, which was retracted (arrow, D; maximum plaque area from 0.15 to 0.10 cm2) after treatments.
Acknowledgements
Funding: Supported by Program for New Century Excellent Talents in University of China (NCET-12-0069).
Disclosure: The authors declare no conflict of interest.
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