Diffuse Brain Hypoperfusion in Advanced Leukoencephalopathy with Calcifications and Cysts

J Stroke Cerebrovasc Dis. 2016 Aug;25(8):e111-3. doi: 10.1016/j.jstrokecerebrovasdis.2016.04.030. Epub 2016 May 19.

Abstract

Leukoencephalopathy with calcifications and cysts (LCC) is an uncommon condition of unknown etiology occurring in children and adults. Pathological findings include obliterative hyalinosis of the small vessels, myelin loss, intense gliosis, Rosenthal fiber formation, microcalcifications, and hemosiderin deposits. Herein we report a 55-year-old man with LCC documented 10 years ago, in whom we examined brain perfusion by pseudocontinuous arterial spin labeling technique. We demonstrated diffused hypoperfusion of the affected white matter (WM) and of the subcortical gray matter (GM) and cortical GM in the patient in comparison to a group of healthy control subjects, using both qualitative evaluation and region of interest analysis. WM and subcortical GM hypoperfusion reflects the known distribution of LCC microangiopathy. We speculate that cortical hypoperfusion may be related to cerebral atrophy or may reflect deafferentation secondary to severe leukoencephalopathy, and may possibly contribute to severe motor and cognitive impairment. Further studies addressing cerebral blood flow in LCC are necessary.

Keywords: 3-T MRI; White matter; arterial spin labeling; neuroimaging; perfusion; perfusion MRI; regional CBF.

Publication types

  • Case Reports

MeSH terms

  • Brain Ischemia / diagnostic imaging
  • Brain Ischemia / etiology*
  • Calcinosis / complications*
  • Calcinosis / diagnostic imaging
  • Cerebrovascular Circulation / physiology
  • Cysts / complications*
  • Cysts / diagnostic imaging
  • Humans
  • Leukoencephalopathies / complications*
  • Leukoencephalopathies / diagnostic imaging
  • Magnetic Resonance Imaging
  • Male
  • Middle Aged