A 36-year-old woman presented with transient diplopia and right-sided paresthesia. MR scan of the brain showed multiple chronic ischaemic lesions in the white matter, linear hyperdensities along sulci and reduced visibility of the middle cerebral arteries (figure 1A– B). Angiography identified progressive narrowing of the internal carotid arteries, with tiny and tortuous lenticulostriate arteries giving a ‘puff of smoke’ appearance, leptomeningeal collaterals from the posterior cerebral arteries and transdural anastomosis (figure 1C–F). Interventional Neuroradiology Unit, Fondazione IRCCS Istituto Neurologico Carlo Besta, Milano, Italy Vascular Neurosurgery Unit, Fondazione IRCCS Istituto Neurologico Carlo Besta, Milano, Italy Cerebrovascular Diseases Unit, Fondazione IRCCS Istituto Neurologico Carlo Besta, Milano, Italy

中文翻译：

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烟雾病

一名 36 岁女性因一过性复视和右侧感觉异常就诊。脑部 MR 扫描显示白质多发慢性缺血性病变，脑沟呈线性高密度，大脑中动脉可见度降低（图 1A-B）。血管造影发现颈内动脉逐渐变窄，豆纹动脉微小而曲折，呈现“烟雾”外观，来自大脑后动脉的软脑膜侧支和经硬膜吻合（图 1C-F）。介入神经放射科，Fondazione IRCCS Istituto Neurologico Carlo Besta，意大利米兰 血管神经外科部门，Fondazione IRCCS Istituto Neurologico Carlo Besta，意大利 脑血管病科，Fondazione IRCCS Istituto Neurologico Carlo Besta，意大利米兰