Imaging features on noncontrast CT suggesting venous infarction with hemorrhage may include atypical distributions not matching arterial vascular territories, infarcts with cortical sparing, typical parasagittal or temporoparietal location, or dural venous/cortical venous hyperdensity suggestive of thrombus. For further discussion of the evaluation of CVT, see Variant 7. MRA Head Without and With IV Contrast There is a limited role for MRA of the head with IV contrast except when dynamic imaging is performed, such as in the setting of known arteriovenous malformations. MRA Head Without IV Contrast In the setting of typical hypertensive hemorrhage, there is no relevant literature to support MRA of the head. However, MRA of the head may be useful in advanced workups to exclude underlying vascular malformations if the etiology is uncertain. In a 2014 review, MRA had a reported sensitivity and specificity exceeding 90% compared with catheter arteriography for detecting intracranial vascular malformations [93]. More recently, MRA was shown to be useful in identifying macrovascular causes such of IPH as aneurysms or arteriovenous malformations [95]. MRA Neck Without and With IV Contrast In the setting of IPH, MRA of the neck is not supported by the literature. MRA of the neck may be useful for treatment planning when endovascular management is expected. MRA Neck Without IV Contrast In the setting of IPH, MRA of the neck is not supported by the literature. MRA of the neck may be useful for treatment planning when endovascular management is expected. MRI Head Perfusion With IV Contrast In the setting of typical hypertensive hemorrhage, there is no relevant literature to support MRI perfusion of the head as a follow-up imaging study.
Cerebrovascular Diseases Stroke and Stroke Related Conditions PCAs. Imaging features on noncontrast CT suggesting venous infarction with hemorrhage may include atypical distributions not matching arterial vascular territories, infarcts with cortical sparing, typical parasagittal or temporoparietal location, or dural venous/cortical venous hyperdensity suggestive of thrombus. For further discussion of the evaluation of CVT, see Variant 7. MRA Head Without and With IV Contrast There is a limited role for MRA of the head with IV contrast except when dynamic imaging is performed, such as in the setting of known arteriovenous malformations. MRA Head Without IV Contrast In the setting of typical hypertensive hemorrhage, there is no relevant literature to support MRA of the head. However, MRA of the head may be useful in advanced workups to exclude underlying vascular malformations if the etiology is uncertain. In a 2014 review, MRA had a reported sensitivity and specificity exceeding 90% compared with catheter arteriography for detecting intracranial vascular malformations [93]. More recently, MRA was shown to be useful in identifying macrovascular causes such of IPH as aneurysms or arteriovenous malformations [95]. MRA Neck Without and With IV Contrast In the setting of IPH, MRA of the neck is not supported by the literature. MRA of the neck may be useful for treatment planning when endovascular management is expected. MRA Neck Without IV Contrast In the setting of IPH, MRA of the neck is not supported by the literature. MRA of the neck may be useful for treatment planning when endovascular management is expected. MRI Head Perfusion With IV Contrast In the setting of typical hypertensive hemorrhage, there is no relevant literature to support MRI perfusion of the head as a follow-up imaging study.