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Transcranial color-coded doppler and digital subtraction angiography in the evaluation of middle cerebral artery abnormality in a patient with neurofibromatosis type 1

In patients with neurofibromatosis type 1 (NF1), cerebral vascular abnormalities can manifest in the form of stenosis, occlusions and aneurysms. In case of arterial obstructions, cerebral perfusion is made possible by the compensation mechanisms of collaterals at different levels. Many imaging methods such as Magnetic Resonance Angiography (MR-A), Computed Tomography Angiography (CT-A), Digital Subtraction Angiography (DSA), and Transcranial Doppler or Transcranial Color-Coded Doppler (TCD/TCCD) can be used to detect structural and hemodynamic changes in the cerebral circulation in these patients. We present the case of a NF1 patient with an anomaly of the left middle cerebral artery. The use of vascular imaging methods allowed elucidating the pathogenetic mechanisms of the vascular disease and planning the follow-up.