Vasculitis

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  • A 35-year-old patient presenting with photophobia and headache was diagnosed with HIV with a CD40 count of 80.
  • Baseline MRI showed an old infarct in the left thalamus. VWI imaging showed concentric enhancement within stenosis in the terminal ICA and MCA.
  • Over the following 4-6 weeks, the mural enhancement was static. The stenoses only minimally progressed but the perfusion to the left and, to a lesser extent, right cerebral hemisphere worsened.
  • With worsening perfusion, an angioplasty successfully widened the stenosis and significantly improved perfusion.