Cryptogenic stroke as initial manifestation of CNS vasculitis: demonstration of vessel wall enhancement on 1.5T MRI using volumetric T1 TSE sequence

Central nervous system (CNS) vasculitis secondary to lupus anticoagulant is a rare but potentially lethal condition. We present a case report of a patient who presented with stroke and subsequently developed basilar artery ectasia and luminal abnormalities secondary to CNS vasculitis associated with antiphospholipid syndrome. We wish to highlight the role of relatively new MRI volumetric single slab 3D fast spin echo (FSE) sequence with slab-elective, variable excitation pulse, resulting in T1-weighting that does not cause vessel lumen enhancement although can show enhancement in inflamed vessel wall and other tissues.