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Images in Neurology |

Diagnosis of Cervical Artery Dissection Using 3-T Magnetic Resonance Imaging

Fu-liang Zhang, MD1; Yang Liu, MD2; Ying-qi Xing, MD, PhD1; Yi Yang, MD, PhD1
[+] Author Affiliations
1Neuroscience Center, Department of Neurology, The First Norman Bethune Hospital of Jilin University, Chang Chun, China
2Department of Radiology, The First Norman Bethune Hospital of Jilin University, Chang Chun, China
JAMA Neurol. 2015;72(5):600-601. doi:10.1001/jamaneurol.2014.4589.
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A previously healthy woman in her 30s presented to the Department of Neurology at First Norman Bethune Hospital of Jilin University with thunderclap neck pain that radiated to the left occiput for 4 days after working for a long time at a computer with lateroversion of the neck. On neurologic examination, there were no other findings but a left Horner syndrome.1 The results from routine hematologic and biochemical tests and computed tomographic brain scan were all normal. The curved planar reformation images from computed tomographic angiography showed tapering stenosis of the left internal carotid artery beginning 2 to 3 cm distal to the bifurcation and extending almost into the skull base (Figure, A). Further investigation of her symptoms was performed to identify the cause of the stenosis.

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Figure.
Radiologic Features of Left Internal Carotid Artery Before and After Therapy

A, The curved planar reformation images of computed tomographic angiography show tapering stenosis of the left internal carotid artery beginning 2 to 3 cm distal to the bifurcation and extending almost into the skull base. B, The T1-weighted volumetric isotropic turbo spin echo acquisition magnetic resonance imaging reveals a crescentic hyperintensity of the left internal carotid artery. C, A repeated T1-weighted volumetric isotropic turbo spin echo acquisition magnetic resonance image 3 months later indicates recanalization of the left internal carotid artery.

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