ANCA-Negative Granulomatosis with Polyangiitis Presenting with Hypertrophic Cranial Pachymeningitis, Abducens Nerve Palsy, and Stenosis of the Internal Carotid Artery

Figure 5

Imaging studies before immunosuppressive treatment (a–d) and 2 years after the initiation of the treatment (e–g). Gadolinium-enhanced T1-weighted MRI of the brain reveals thickening of enhanced dura mater extending from the cavernous sinus to the clivus on axial (a) and coronal (b) images (triangle). Narrowing at the C5 portion of the internal carotid artery (ICA) is apparent on axial (a) and coronal (b) MRI, MRA (c), and lateral cerebral angiography of the ICA (d) (arrow). Thickening of the dura mater and stenosis of the ICA improved on axial (e) and coronal (f) MRI and MRA (g).

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