Longitudinal 7T MRI Vessel Wall Imaging in Middle Cerebral Artery Dissection: A 210-Day Case Study

Motivation: Middle cerebral artery dissection (MCAD) is a key cause of stroke in young adults, but its long-term progression is poorly understood due to limited follow-up frequency. Goal(s): This study aims to capture dynamic vessel wall changes in MCAD over 210 days using 7T high-resolution vessel wall imaging. Approach: We monitored a patient with isolated MCAD across multiple follow-ups, employing HRVWI, TOF-MRA, and SWI. Results: Key stages observed were symptom improvement with dual antiplatelet therapy, dissection adhesion, recanalization, inflammatory stenosis, and eventual stabilization, offering insights into MCAD's natural course and markers for prognosis. Impact: This study demonstrates the potential of 7T HRVWI for capturing long-term vessel wall changes in MCAD, providing critical insights into disease progression and markers for treatment response, which could enhance diagnostic and prognostic strategies in cerebrovascular care.