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CC BY 4.0 · Arq Neuropsiquiatr 2022; 80(07): 763-764
DOI: 10.1055/s-0042-1755279
Images in Neurology

Vessel wall MRI in the dissecting pseudoaneurysm related to Parry-Romberg syndrome

Estudo de parede vascular por ressonância magnética em pseudoaneurisma dissecante associado a síndrome de Parry-Romberg
André Vaz 
1   Hospital Pequeno Príncipe, Centro de Imagem, Curitiba PR, Brazil.
2   Universidade Federal do Paraná, Programa de Pós-graduação em Medicina Interna, Curitiba PR, Brazil.
,
Bernardo Corrêa de Almeida Teixeira 
1   Hospital Pequeno Príncipe, Centro de Imagem, Curitiba PR, Brazil.
2   Universidade Federal do Paraná, Programa de Pós-graduação em Medicina Interna, Curitiba PR, Brazil.
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A 7-year-old girl with a previous diagnosis of Parry-Romberg syndrome presented with acute headache ([Figures 1] and [2]). Parry-Romberg syndrome is a subtype of localized scleroderma of the head that, although rare, may be associated with giant intracranial aneurysms.[1] The etiology of these aneurysms is still poorly understood; however, it is believed that it may be related to endothelial inflammatory injury or vasa vasorum microangiopathy and vascular wall ischemia.[1] [2] Dissecting pseudoaneurysm of intracranial arteries is rare and may result in acute headache and neurological deficits.[1] [2] The characterization of mural enhancement in vessel wall magnetic resonance imaging (MRI) in this case corroborated the hypothesis of a vasculitis-related etiology.

Zoom Image
Figure 1 Volume-rendered time-of-flight angiography. The superior view depicts the dissecting pseudoaneurysm of the basilar artery (arrow) and a right internal carotid artery aneurysm (arrowhead).
Zoom Image
Figure 2 Vessel Wall MRI. Precontrast (A), postcontrast (B), and image fusion (C) depict the dissecting pseudoaneurysm of the basilar artery composed of a large subadventitial hematoma (asterisks) associated with inflammatory changes (short arrows). Note the circumferential wall enhancement of the basilar artery causing stenosis (long arrows) and right internal carotid artery aneurysm (arrowheads).

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Conflict of Interest

The authors have no conflict of interests to declare.

Authors' Contributions

AV: collected the data, conceived the analysis, and wrote and reviewed the paper; BCAT: guided the preparation of the work, and wrote and reviewed the paper.


  • References

  • 1 Bosman T, Van Bei Jnum J, Van Walderveen MAA, Brouwer PA. Giant intracranial aneurysm in a ten-year-old boy with parry romberg syndrome. A case report and literature review. Interv Neuroradiol 2009; 15 (02) 165-173
    CrossrefPubMedGoogle Scholar
  • 2 Kuechler D, Kaliaperumal C, Hassan A, Fanning N, Wyse G, O'Sullivan M. Aneurysmal subarachnoid haemorrhage in Parry-Rhomberg syndrome. BMJ Case Rep 2011; 2011: bcr1020114920
    CrossrefPubMedGoogle Scholar

Address for correspondence

André Vaz

Publication History

Received: 20 December 2021

Accepted: 06 February 2022

Article published online:
29 September 2022

© 2022. Academia Brasileira de Neurologia. This is an open access article published by Thieme under the terms of the Creative Commons Attribution 4.0 International License, permitting copying and reproduction so long as the original work is given appropriate credit (https://creativecommons.org/licenses/by/4.0/)

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  • References

  • 1 Bosman T, Van Bei Jnum J, Van Walderveen MAA, Brouwer PA. Giant intracranial aneurysm in a ten-year-old boy with parry romberg syndrome. A case report and literature review. Interv Neuroradiol 2009; 15 (02) 165-173
    CrossrefPubMedGoogle Scholar
  • 2 Kuechler D, Kaliaperumal C, Hassan A, Fanning N, Wyse G, O'Sullivan M. Aneurysmal subarachnoid haemorrhage in Parry-Rhomberg syndrome. BMJ Case Rep 2011; 2011: bcr1020114920
    CrossrefPubMedGoogle Scholar

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Zoom Image
Figure 1 Volume-rendered time-of-flight angiography. The superior view depicts the dissecting pseudoaneurysm of the basilar artery (arrow) and a right internal carotid artery aneurysm (arrowhead).
Zoom Image
Figure 2 Vessel Wall MRI. Precontrast (A), postcontrast (B), and image fusion (C) depict the dissecting pseudoaneurysm of the basilar artery composed of a large subadventitial hematoma (asterisks) associated with inflammatory changes (short arrows). Note the circumferential wall enhancement of the basilar artery causing stenosis (long arrows) and right internal carotid artery aneurysm (arrowheads).