MRI
Axial T1
Axial T2
Axial FLAIR
Axial MRA
Axial 3D TOF COW
Lt carotid MRA
Lt carotid MRA
Lt COW MRA
Rt carotid MRA
Rt carotid MRA
Rt COW MRA
Axial DWI
On all sequences, it is clear that no flow is observed within the left internal carotid artery from the base of the skull to the cavernous sinus region. The MRI images showed flow within the left anterior and middle cerebral arteries which fill via the anterior communicating artery.
The MR angiogram of the intracranial circulation shows some, irregular flow in the petrous portion of the left internal carotid artery however most of the hypersignal noted in this region is "shine through" from the actual clot.
These studies are compatible with left internal carotid artery dissection. There is no evidence of acute infarct. MRA with gadolinium recommended and MR perfusion studies.
The MR angiogram of the extracranial arterial circulation shows a 1cm stump and then no further flow in the left internal carotid artery. The other arteries are of normal flow and caliber.
These studies are compatible with left internal carotid artery dissection. There is no evidence of acute infarct.