For example, recent studies have demonstrated concentric thickening of the vessel wall with minimal or no enhancement in RCVS, compared with more eccentric wall thickening and significant wall enhancement in cases of vasculitis [12]. In addition, vessel wall imaging can be used to help identify the ruptured lesion when initial CTA reveals multiple aneurysms [11]. Headache MRI Head Without IV Contrast There is no relevant literature to support the use of MRI head without IV contrast in the initial imaging evaluation of TCH; it may have utility in follow-up evaluation after initial neuroimaging. Brain MRI has been shown to have high sensitivity for SAH when using fluid-attenuated inversion recovery (FLAIR) and T2* or susceptibility-weighted images, especially in the acute phase. FLAIR has been demonstrated to be useful for detecting peripheral or sulcal SAH, and T2* has been demonstrated to be useful for detecting cisternal or intraventricular hemorrhage. However, other studies have identified additional causes of sulcal FLAIR hyperintensity, which is therefore not a specific finding for SAH. Brain MRI has higher contrast resolution than head CT, and as a follow-up examination, it can help delineate parenchymal changes from various other non-SAH etiologies of TCH including RCVS, CVT, and pituitary apoplexy [13,19,20]. MRV Head With IV Contrast There is no relevant literature to support the use of MR venography (MRV) head with IV contrast in the initial imaging evaluation of TCH. Brain MRV can be used as a follow-up imaging study in cases of suspected CVT [11]. MRV Head Without and With IV Contrast There is no relevant literature to support the use of MRV head without and with IV contrast in the initial imaging evaluation of TCH. Brain MRV can be used as a follow-up imaging study in cases of suspected CVT [11]. MRV Head Without IV Contrast There is no relevant literature to support the use of MRV head without IV contrast in the initial imaging evaluation of TCH.
Headache PCAs. For example, recent studies have demonstrated concentric thickening of the vessel wall with minimal or no enhancement in RCVS, compared with more eccentric wall thickening and significant wall enhancement in cases of vasculitis [12]. In addition, vessel wall imaging can be used to help identify the ruptured lesion when initial CTA reveals multiple aneurysms [11]. Headache MRI Head Without IV Contrast There is no relevant literature to support the use of MRI head without IV contrast in the initial imaging evaluation of TCH; it may have utility in follow-up evaluation after initial neuroimaging. Brain MRI has been shown to have high sensitivity for SAH when using fluid-attenuated inversion recovery (FLAIR) and T2* or susceptibility-weighted images, especially in the acute phase. FLAIR has been demonstrated to be useful for detecting peripheral or sulcal SAH, and T2* has been demonstrated to be useful for detecting cisternal or intraventricular hemorrhage. However, other studies have identified additional causes of sulcal FLAIR hyperintensity, which is therefore not a specific finding for SAH. Brain MRI has higher contrast resolution than head CT, and as a follow-up examination, it can help delineate parenchymal changes from various other non-SAH etiologies of TCH including RCVS, CVT, and pituitary apoplexy [13,19,20]. MRV Head With IV Contrast There is no relevant literature to support the use of MR venography (MRV) head with IV contrast in the initial imaging evaluation of TCH. Brain MRV can be used as a follow-up imaging study in cases of suspected CVT [11]. MRV Head Without and With IV Contrast There is no relevant literature to support the use of MRV head without and with IV contrast in the initial imaging evaluation of TCH. Brain MRV can be used as a follow-up imaging study in cases of suspected CVT [11]. MRV Head Without IV Contrast There is no relevant literature to support the use of MRV head without IV contrast in the initial imaging evaluation of TCH.