Vertebral artery occlusion - hemorrhagic infarct

Case contributed by Paresh K Desai
Diagnosis almost certain

Presentation

Sudden onset altered sensorium and right hemiparesis.

Patient Data

Age: 35 years
Gender: Male

Note: This case has been tagged as "legacy" as it no longer meets image preparation and/or other case publication guidelines.

Complete occlusion of left vertebral artery

Cytotoxic edema involving the right occipital lobe with associated hemorrhagic component.

Case Discussion

MR reveals an infarct in the left posterior MCA and MCA-PCA watershed territories. The T1 sagittal image reveals subacute hemorrhage within the infarct. 

MR angiography reveals - complete occlusion of left vertebral artery - presumed dissection.

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