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Images in Neurology |

Basilar Artery Branch Disease Imaged by Magnetic Resonance Imaging

Manu Mehdiratta, MD, FRCPC; Louis R. Caplan, MD; Sandeep Kumar, MD
Arch Neurol. 2007;64(11):1666. doi:10.1001/archneur.64.11.1666.
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We evaluated a 60-year-old man with hypertension and diabetes who presented with dysarthria and left-sided weakness. Diffusion-weighted magnetic resonance (MR) imaging showed an infarct in the right paramedian pontine distribution (Figure 1). This area is supplied by perforators from the basilar artery. T2-weighted MR imaging revealed a plaque in the midbasilar artery at the level of the pontine perforators (Figure 2). Results of the MR angiogram were normal. The lesion site in the basilar artery and the pontine infarction suggest a causal link.

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Figure 1.

T2-weighted magnetic resonance image of the rostral pons reveals a basilar plaque (arrow) at the level of the pontine perforators.

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Figure 2.

Diffusion-weighted magnetic resonance image reveals an infarct (arrow) at the level of the rostral pons corresponding with the basilar artery plaque seen on T2-weighted magnetic resonance imaging.

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