High-resolution MRI of radiation-induced intracranial vasculopathy

A 46-year-old woman without traditional stroke risk factors presented with acute left limbs numbness. Two years prior, she had a right cranio-orbital junction meningioma resected and received radiation therapy (target dose DT 60 Gy/30 F, 5 F/W, 2 Gy/F). MRI revealed a diffusion-positive focus within the anterior periventricular white matter. CT angiography showed >50% right middle cerebral artery (MCA) stenosis. High-resolution MRI (HRMRI) suggested concentric vessel wall thickening with contrast enhancement (figure).