Imaging Findings
Sagittal Echoencephalogram demonstrates linear echogenic foci in the distribution
of the lenticulostriate branches of the middle cerebral artery in the basal
ganglia and the thalami, bilaterally(A,B). Color Doppler confirming the
presence of flow in these arteries(C).
Imaging Diagnosis
Mineralising Vasculopathy
Discussion
The entity mineralizing vasculopathy has been infrequently described
in literature. On echoencephalograms, it is seen as branched linear pattern
of echogenicity in the course of the lenticulostriate branches of the
middle cerebral arteries in the basal ganglia and the thalami. Pathologically
the various hypotheses for these echogenicities include deposition of
amorphous basophilic material, perivascular infiltrates of mononuclear
cells, hyalinized thickening of the arterial wall or rarely a true vasculitis
(1). Deposition of calcium does not occur, explaining the lack of corresponding
hyperdensities in the basal gangia on CT scanning.
No specific cause has been attributed to this finding. This finding can
be seen in a variety of conditions including congenital infection(especially
CMV), trisomy 13, maternal diabetes, traumatic injury, non-immune hydrops
and fetal alcohol syndrome(2). Sometimes no underlying disorder can be
found.
This finding should encourage further laboratory and chromosomal investigation
for congenital infections or chromosomal abnormality.
References
1.Teele RL, Hernanz-Schulman M, and Sotrel A. Echogenic vasculature
in the basal ganglia of neonates: a sonographic sign of vasculopathy.
Radiology 169:423-427, 1988.
2. Wang, HS, Kuo MF, and Chang TC. Sonographic lenticulostriate
vasculopathy in infants: some associations and a hypothesis. AJNR 16:97-102,
1995.
Contribution
DR SUDHA LOLAYEKAR & DR GAURAV SAIGAL
GSaigal@med.miami.edu
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