West Nile virus-associated vasculitis and intracranial hemorrhage

Adil Harroud; Ahmad Almutlaq; David Pellerin; Dan Paz; Grant J. Linnell; Daniel Gendron

doi:10.1212/NXI.0000000000000641

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Figure MRI and DSA
(A) Axial susceptibility-weighted image showing prominent blooming (arrows) in the sulci of the bilateral posterior parietal regions at the vertex, frontal lobes, and sylvian fissures, indicating subarachnoid hemorrhage. (B) DSA showing mild tapered stenosis in the proximal extent of the A2 segment of the left anterior cerebral artery (oval circle) and mild focal ectasia of left angular artery (rectangle). (C) Follow-up MRI demonstrating a new small left frontal intracerebral hemorrhage (arrow) on an axial susceptibility-weighted image. (D) Concentric gadolinium enhancement of the supraclinoid segment of the internal carotid arteries and proximal middle cerebral arteries bilaterally (arrows), seen on magnetic resonance vessel wall imaging. (E) Follow-up DSA showing interval resolution of the vascular changes previously noted in the A2 segment of the left anterior cerebral artery (oval circle) and left angular artery (rectangle). DSA = digital subtraction angiography.

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West Nile virus-associated vasculitis and intracranial hemorrhage

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