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Training Collections
Library Memberships
Black Friday Save 30%On-demand course library with video lectures, expert case reviews, and more
Fellowship Certificate™ Programs
Black Friday Save 30%Practice-focused training programs designed to help you gain experience in a specific subspecialty area.
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Black Friday Save 40%Unlock access to our full Course Library and all self-paced Fellowships.
Noon Conference (Free)
Get access to free live lectures, every week, from top radiologists.
Case of the Week (Free)
Get a free weekly case delivered right to your inbox.
Dr. Resnick's MSK Conference
BLACK FRIDAY SAVE 30%Learn directly from the MSK Master himself.
Lower Extremities MRI Conference
Musculoskeletal Imaging
Emergency Imaging
PET Imaging
Pediatric Imaging
For Training Programs
Supplement your training program with case-based learning for residents, registrars, fellows, and more.
For Private Practices
Upskill in high growth, advanced imaging areas.
Emergency Call Prep
Prepare trainees to be on call for the emergency department with this specialized training series.
Lesson
Pre-Course Activities
1 topic, 3 min.
Lesson
Introduction to Stroke Imaging
4 topics, 17 min.
Lesson
Noncontrast CT
5 topics, 14 min.
Lesson
CTA Neck
10 topics, 33 min.
Vascular Imaging in Stroke - CTA vs MRA
2 m.Carotid and Vertebral Vasculopathies Overview & Examples of Atherosclerotic Disease
3 m.Case - Atheromatous Disease with Severe ICA Stenosis
4 m.Carotid & Vertebral Artery Dissection Overview & Examples
3 m.Case - Embolic Stroke with ICA Dissection
5 m.Collagen Vascular Diseases Overview - Examples of FMD, Carotid Web
2 m.Case - Fibromuscular Dysplasia (FMD)
5 m.Case - Ehlers Danlos
7 m.Inflammatory Conditions with Stroke Symptoms - Examples of Takayasu's, TIPIC
4 m.Case - Takayasu’s Arteritis
4 m.Lesson
CTA Head
9 topics, 37 min.
CTA Head in Acute Stroke - Source Images, MIPS, Collaterals
4 m.Case - MCA Stem Embolus with Good Collaterals
5 m.Case - MCA Stem Embolus with Poor Collaterals
4 m.Case - Basilar Tip Thrombus
6 m.Circle of Willis Stenoses: Differential Diagnoses
2 m.Case - Moya Moya disease
6 m.Case - Reversible Cerebral Vasoconstrictive Syndrome (RCVS)
5 m.Case - Primary Angiitis of the CNS (PACNS)
7 m.Infectious Causes of Multifocal Circle of Willis Stenosis
2 m.Lesson
CT Perfusion
3 topics, 15 min.
Lesson
MRI (DWI, FLAIR, SWI) of Acute Stroke
3 topics, 14 min.
Lesson
MRA of Head and Neck
6 topics, 18 min.
Lesson
Multifocal Strokes With No Visualized Vascular Abnormality
6 topics, 26 min.
Lesson
Brain Ischemia, Hypoxia, & Death
6 topics, 16 min.
Lesson
Stroke Mimics & Other Causes of Restricted Diffusion
7 topics, 18 min.
Stroke Mimics - Other Causes of Restricted Diffusion
2 m.Case - Seizure (Stroke Mimic)
4 m.Case - MELAS (Stroke Mimic)
3 m.Case - Hypoglycemia (Stroke Mimic)
3 m.Case - Herpes Virus Encephalitis (Stroke Mimic)
4 m.Case - Osmotic Demyelination Syndrome (Stroke Mimic)
3 m.Case - Brain Metastases (Stroke Mimic)
4 m.Lesson
MR Perfusion
8 topics, 17 min.
MR Perfusion - Data, Maps and Uses
4 m.Case - MR Perfusion Target Mismatch (Good Collaterals)
2 m.Case - MR Perfusion Target Mismatch (Poor Collaterals)
3 m.Case - Ischemia Detected Only on MR Perfusion (Case 1)
2 m.Case - Ischemia Detected Only on MR Perfusion (Case 2)
3 m.Arterial Spin Labelling Perfusion - Usage Examples
3 m.Case - ASL Matched Defect
2 m.Case - ASL Showing Tissue at Risk
2 m.Lesson
Subacute Stroke & Differentials
5 topics, 13 min.
0:01
So now, we'll talk a little bit about
0:02
collagen vascular diseases.
0:04
The most common is fibromuscular dysplasia.
0:06
It's seen in young Caucasian females.
0:09
Pathologically,
0:10
there are rings of fibrous tissue and smooth muscle.
0:13
And so, what you get is a string of beads.
0:16
And here's an example of a patient who has this
0:20
string of beads appearance throughout her right
0:22
cervical ICA to the left or extent
0:25
in the left cervical ICA.
0:28
And this is another patient who
0:29
has left cervical ICA beading.
0:32
So, that's what the classic spring
0:34
of beads appearance looks like.
0:36
25% to 30% of patients with FMD,
0:39
systemic FMD, like they have it in their kidneys,
0:42
also have intracranial FMD.
0:44
Of the patients who have intracranial FMD,
0:46
95% involve the ICA,
0:48
and 12% to 40% involve the vertebral artery.
0:51
It's very common to have it more in one vessel.
0:55
And FMD is responsible for 15% of spontaneous
0:58
cervical carotid dissections.
1:01
So, carotid web is thought to be a variant of FMD.
1:05
And on pathologies, there's thickened intimal
1:08
fibrous tissue that projects into the lumen.
1:11
This is seen in middle-aged patients who have
1:13
recurrent strokes.
1:14
And this is what you see,
1:17
you see a thin linear filling defect in the
1:21
posterior wall of the carotid bulb.
1:24
It looks exactly like that
1:25
on reconstructed images.
1:26
And you have to be really careful when you're
1:28
looking at axial images because you'll see,
1:30
you know, basically, the normal common,
1:32
and then you...
1:33
common carotid,
1:33
and then you just see this in the proximal internal.
1:35
You see on two images.
1:36
Remember, you're looking at 1000 images.
1:39
So, when you're looking at the bifurcating,
1:40
you have to go through it slowly.
1:41
This is a classic carotid web.
1:43
And the patient had an MCA embolus,
1:45
as you can see on this MIP reconstruction,
1:48
and had a small MCA stroke
1:50
involving the right lentiform nucleus.
1:52
So, remember to look closely at the carotid bulb
1:56
when you're looking at your images
1:57
because this can be easily missed.
Collagen Vascular Diseases Overview - Examples of FMD, Carotid Web
HIDEInteractive Transcript
0:01
So now, we'll talk a little bit about
0:02
collagen vascular diseases.
0:04
The most common is fibromuscular dysplasia.
0:06
It's seen in young Caucasian females.
0:09
Pathologically,
0:10
there are rings of fibrous tissue and smooth muscle.
0:13
And so, what you get is a string of beads.
0:16
And here's an example of a patient who has this
0:20
string of beads appearance throughout her right
0:22
cervical ICA to the left or extent
0:25
in the left cervical ICA.
0:28
And this is another patient who
0:29
has left cervical ICA beading.
0:32
So, that's what the classic spring
0:34
of beads appearance looks like.
0:36
25% to 30% of patients with FMD,
0:39
systemic FMD, like they have it in their kidneys,
0:42
also have intracranial FMD.
0:44
Of the patients who have intracranial FMD,
0:46
95% involve the ICA,
0:48
and 12% to 40% involve the vertebral artery.
0:51
It's very common to have it more in one vessel.
0:55
And FMD is responsible for 15% of spontaneous
0:58
cervical carotid dissections.
1:01
So, carotid web is thought to be a variant of FMD.
1:05
And on pathologies, there's thickened intimal
1:08
fibrous tissue that projects into the lumen.
1:11
This is seen in middle-aged patients who have
1:13
recurrent strokes.
1:14
And this is what you see,
1:17
you see a thin linear filling defect in the
1:21
posterior wall of the carotid bulb.
1:24
It looks exactly like that
1:25
on reconstructed images.
1:26
And you have to be really careful when you're
1:28
looking at axial images because you'll see,
1:30
you know, basically, the normal common,
1:32
and then you...
1:33
common carotid,
1:33
and then you just see this in the proximal internal.
1:35
You see on two images.
1:36
Remember, you're looking at 1000 images.
1:39
So, when you're looking at the bifurcating,
1:40
you have to go through it slowly.
1:41
This is a classic carotid web.
1:43
And the patient had an MCA embolus,
1:45
as you can see on this MIP reconstruction,
1:48
and had a small MCA stroke
1:50
involving the right lentiform nucleus.
1:52
So, remember to look closely at the carotid bulb
1:56
when you're looking at your images
1:57
because this can be easily missed.
Report
Faculty
Pamela W Schaefer, MD, FACR
Professor of Radiology, Vice Chair of Education
Massachusetts General Hospital
Tags
Vascular Imaging
Vascular
Neuroradiology
Neuro
Head and Neck
CTA
Brain
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