Case of the Week
Section Editors: Matylda Machnowska1 and Anvita Pauranik2
1University of Toronto, Toronto, Ontario, Canada
2BC Children's Hospital, University of British Columbia, Vancouver, British Columbia, Canada
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September 26, 2011
Lenticulostriate Vasculopathy (LV)
- LV, though debatable, is also known as mineralizing vasculopathy or necrotizing vasculopathy.
- Seen in up to 27% of patients with congenital CMV, as in this case.
- Lenticulostriate vasculopathy is associated with TORCH infections such as toxoplasmosis and CMV. It is also seen in recipients in twin-twin transfusion, trisomy 13 and 21, maternal drug use, and congenital heart disease. It can be idiopathic in etiology, particularly if it is unilateral.
- The stenotic or obstructed lumina and possible changes in the wall of these lenticulostriate arteries have been speculated to cause echogenic stripes on the gray-scale sonographic study.
- Key Diagnostic Features: On ultrasound, bright linear "branched candlestick" stripes in the basal ganglia region are highly suggestive of LV. When associated with periventricular cysts, especially in the temporal region, the diagnosis of TORCH should be considered. Other findings in CMV infection—not demonstrated in the current case but usually seen—include calcifications, migrational anomalies, and ventricular dilatation.
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