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Fig. 4 | BMC Neurology

Fig. 4

From: Progressive stenosis and radiological findings of vasculitis over the entire internal carotid artery in moyamoya vasculopathy associated with graves’ disease: a case report and review of the literature

Fig. 4

Cerebral angiograms in the second episode, 1 year and 2 years later. a Cerebral angiograms of the terminal portion of the left ICA in the second episode showed severe stenosis of the distal portion. b Cerebral angiograms of the proximal left ICA showed stenosis at proximal ICA and CBN in the second episode. c Cerebral angiograms 12 months after the second episode showed progression of stenosis of the distal portion and net-like vessels might have been developed (arrowhead-yellow), but incomplete occlusion (arrow). d Cerebral angiograms 24 months after the second episode showed improved blood flow in the left ACA, MCA and ICA (arrowhead-white), as well as mild improvement of stenosis of the terminal portion of the left ICA (dashed arrow). We consider that since the progression of MMV stopped after administration of PSL and MTX, and in the euthyroid state, cerebral angiograms did not show complete occlusion of distal ICA. Afterward, the net-like vessels might have developed only in the limited space around the distal ICA region. Improved blood flow through the net-like vessels and mild improvement of stenosis in cerebral arteries on cerebral angiograms might have increased blood flow in the left ICA and MCA on MRA

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