As increased optimization of 3T occurs one would expect further improvements in sensitivity and validity. Our preliminary results indicate that brain 3T FLAIR lesion detection likely was not sufficient to uncover the full extent of clinically relevant tissue damage, as correlations with both clinical and cognitive measures selleck chemical remained moderate. Consistent with this hypothesis, we have reported separately that 3T FLAIR lesion assessments do not capture the full extent of white matter pathology, which can be detected with advanced MRI measures such as T2 relaxometry.46 Additional techniques useful for detecting diffuse occult damage, such as diffusion tensor imaging,47,48 magnetization transfer,49 and MR spectroscopy,50

have shown relationships with cognitive measures. Brain activation and adaptive cortical changes related to cognitive function between MS patients and normal controls are also being elucidated with functional MRI.51 Volumetric MRI analysis also has shown promise in helping to link cognitive impairment and MS-related damage, such as regional atrophy in the hippocampus,52 thalamus,53 and general gray matter42 showing stronger correlations

than conventional measures. “
“We report the case of a 67-year-old man with repeating cerebral embolism caused by a dolichoectatic right common carotid artery. The patient had a history of hypertension, hypercholesterolemia, cigarette smoking, and a postoperative abdominal aortic aneurysm. He presented Selleck ZD1839 with a sudden onset of weakness of the left arm and leg. Magnetic resonance imaging revealed old and fresh infarction in the right cerebral hemisphere. Carotid duplex ultrasonography showed a dolichoectatic right common carotid artery with a maximum diameter of 39 mm with thick plaque and strong spontaneous echo contrast. L-gulonolactone oxidase The flow velocity was considerably reduced, which caused thrombus formation, and strong antithrombotic therapy was required. This case provides a rare example of ischemic stroke caused by extracranial carotid artery dolichoectasia.

Dolichoectasia is a dilatative arteriopathy characterized by an increase in the arterial length and diameter that causes ischemic stroke.1986 Dolichoectasia most frequently involves the vertebrobasilar artery, and occurs less often in the intracranial carotid artery and middle cerebral artery (MCA).2003, 1998 Extracranial carotid artery (ECA) dolichoectasia is particularly rare, but can cause ischemic events. Ischemic stroke induced by dolichoectasia is associated with penetrating branch territory infarcts such as those in the pons.1998, 2003 Transcranial Doppler (TCD) studies of dolichoectatic arteries show reduced blood flow velocities1987 that can induce thrombus formation within the dilated lumen, and the luminal thrombus can embolize distally.1999 Here, we report the case of a patient with a dolichoectatic common carotid artery (CCA) that caused repeated embolism.