V sign (midbrain)

Last revised by Rohit Sharma on 27 Feb 2024

The V sign is a radiological sign described in ischemic stroke in the territory of the artery of Percheron when affecting the midbrain.

The V sign describes refers to the hyperintensity seen on axial FLAIR and DWI MRI along the pial surface of the midbrain that forms the posterior wall of the interpeduncular fossa, which resembles the letter V 1-4. This sign is positive in 30-67% of patients with artery of Percheron infarction involving the midbrain 1,2.

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