Figure Vertebral artery angiogram and tissue pathology

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Presentation transcript:

Figure Vertebral artery angiogram and tissue pathology Vertebral artery angiogram and tissue pathology Vertebral angiogram at time of diagnosis (A and C) showing multiple areas of narrowing and aneurysmal enlargement of extracranial branches of both vertebral arteries at C2 and C3 and the radiculomedullary artery supplying the anterior spinal artery at the C5-C6 level. Repeat angiogram after 6 months of therapy (B and D) showing marked improvement. Hematoxylin & eosin stain of cervical muscle biopsy specimen (E) showed thickening of the vascular walls (arrow), perivascular fibrosis, and obliterated lumen (arrowhead). Immunostaining for T cells with anti-CD3 (F) showing T-cell infiltration within the vascular wall (arrows). The biopsy also showed focal disruption of the vascular smooth muscle, recanalization, macrophages within the vessel walls, and perivascular iron deposits, consistent with the healing stage of vasculitis (not shown). Neha Garg et al. Neurol Neuroimmunol Neuroinflamm 2014;1:e7 © 2014 American Academy of Neurology