PICA termination of hypoplastic vertebral artery

Case contributed by Dr Gaurav Som Prakash Gupta



Patient Data

Age: 40
Gender: Male



The presented images are from a TOF MRA of brain and neck. There is no definite stenotic segment. However, the images show:

Case Discussion

The MR study of this patient showed an approximately 12 x 9 mm subacute infarction in the left caudate nucleus (not shown in these images).

The presented images are from TOF MRA of brain and neck. There is no definite stenotic segment. 

However, the images show a markedly hypolastic right vertebral artery which is terminating in to the PICA (posterior inferior cerebellar artery). This likely to be hypoplasia rather than stenosis, as the narrowing is involving the entire course of the vertebral artery and there is no segment of abrupt change in caliber. Also there is no wall irregularity. The ostea of the vertebral artery, which is commonest site of vertebral stenosis stenosis, also appears normal.

The case highlights a variation of the vertebral artery circulation: a thin vertebral artery ending into PICA.

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