The suboccipital rind sign is a radiological sign described in CT angiography of vertebral artery dissection. In some instances, presence of the suboccipital rind sign may be the only radiographic evidence of vertebral artery dissection on CT angiography 1.
The suboccipital rind sign describes the appearance on axial CT angiography of a dissected V3 segment of the vertebral artery, whereby there is non-enhancing, thickening of the posterior vessel wall, in the absence of any luminal narrowing or irregularity 1,2. This sign is specifically seen in the horizontal portion of the V3 segment of the vertebral artery that traverses over the groove of the posterior arch of the atlas, and represents intramural hematoma from focal dissection at this location 1,2.
Differential diagnosis
normal vertebral venous plexus or suboccipital cavernous sinus: enhances with contrast 1
normal obliquus capitis inferior muscle 1
mural thickening secondary to vasculitis (e.g. giant cell arteritis) 1
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