2023 ARRS ANNUAL MEETING - ABSTRACTS

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E1627. Cerebrovascular Disease in Young Adults: A Case-Based Review
Authors
  1. Huijuan Wang; Trinity Health St Joseph Mercy Oakland Hospital; Wayne State University
  2. Serguei Medvedev; Trinity Health St Joseph Mercy Oakland Hospital; Wayne State University
  3. Alexander Satei; Trinity Health St Joseph Mercy Oakland Hospital; Wayne State University
  4. Nicholas Mills; Trinity Health St Joseph Mercy Oakland Hospital; Wayne State University
  5. Kaitlin Zaki-Metias; Trinity Health St Joseph Mercy Oakland Hospital; Wayne State University
  6. George Pappas; Huron Vally Radiology
Background
Cerebrovascular disease (CVD) can result from blood vessel narrowing, rupture, or a hypercoagulable state, which may present on imaging as vascular stenosis, hemorrhage, or occlusion, respectively. As an emerging public health issue with debilitating effects on young adults, recognizing the similarities and differences between young adults and elderly patients for the etiologies and prevalence of various types of CVD is imperative for optimal patient outcomes. For the purposes of our study, young adults are defined as those aged 18 - 50 years old.

Educational Goals / Teaching Points
Our presentation includes a review of the common etiologies and prevalence of CVD in young adults and how this compares to elderly patients. We then categorize the differential diagnosis based on the general imaging appearance of vascular stenosis, hemorrhage, and occlusion. This is followed by multiple vignette-style young adult CVD cases to practice the diagnostic approach that was previously reviewed. There are questions accompanying each case focused on differential diagnosis, prognosis, and management. Following each case, the clinical presentation, key imaging findings, differential diagnosis, and management are discussed.

Key Anatomic/Physiologic Issues and Imaging Findings/Techniques
Various imaging modalities are presented in the cases along with discussion about the value of each modality in evaluation of CVD, such as computed tomography (CT), CT angiography, CT venography, catheter angiography, magnetic resonance imaging (MR), MR angiography, and MR venography. The CVD cases we present include Moyamoya disease, hypertensive cerebral hemorrhage, cerebral aneurysm, dural venous thrombosis, traumatic vertebral artery dissection, developmental venous anomaly, acute ischemic infarction, and more.

Conclusion
It is important to recognize the similarities and differences of the prevalence and etiology of CVD in young adults and elderly patients, as timely diagnosis is crucial for optimal outcomes. After reviewing this educational exhibit, the participants should be confident to discuss the use of various imaging modalities, imaging findings, differential diagnosis, and management of common young adult CVD with the clinicians.