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Fluid-attenuated inversion recovery (FLAIR) is a magnetic resonance imaging sequence with an inversion recovery set to null fluids. For example, it can be used in brain imaging to suppress cerebrospinal fluid (CSF) effects on the image, so as to bring out the periventricular hyperintense lesions, such as multiple sclerosis (MS) plaques. [ 1 ]
The term "leukoaraiosis" was coined in 1986 [6] [7] by Hachinski, Potter, and Merskey as a descriptive term for rarefaction ("araiosis") of the white matter, showing up as decreased density on CT and increased signal intensity on T2/FLAIR sequences (white matter hyperintensities) performed as part of MRI brain scans.
MRI scans showing hyperintensities. A hyperintensity or T2 hyperintensity is an area of high intensity on types of magnetic resonance imaging (MRI) scans of the brain of a human or of another mammal that reflect lesions produced largely by demyelination and axonal loss.
Fluid attenuated inversion recovery (FLAIR) vascular hyperintensity (FVH) is a radiographic marker seen on brain imaging in acute ischaemic stroke. FVH can be used as a proxy for slow leptomeningeal collateral blood flow, and may help reveal which areas of brain tissue are potentially salvageable. [12]
Fluid-attenuated inversion recovery (FLAIR) [2] is an inversion-recovery pulse sequence used to nullify the signal from fluids. For example, it can be used in brain imaging to suppress cerebrospinal fluid so as to bring out periventricular hyperintense lesions, such as multiple sclerosis plaques.
Imaging at 6, 12, and 24 months and repeat hormonal evaluation yearly for 4 years is often recommended, [6] but there exists controversy about harm/benefit of such screening as there is a high subsequent false-positive rate (about 50:1) and overall low incidence of adrenal carcinoma. [8]
[1] [5] [6] Some consider that the abnormalities need to be shown to be reversible. [4] [5] If lumbar puncture is performed this may show increased protein levels but no white blood cells. [1] [3] [4] Computed tomography scanning may be performed in the first instance; this may show low density white matter areas in the posterior lobes. [4]
The supratentorial region contains the cerebrum, while the infratentorial region contains the cerebellum. Although the Roman era anatomist Galen commented upon it, the functional significance of this neuroanatomical division was first described using ‘modern’ terminology by John Hughlings Jackson, founding editor of the medical journal Brain.