PMC9853924_01
Axial DWI MRI showing hyperintensity in right parietal lobe adjacent to sylvian fissure.
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A cerebral axial diffusion-weighted magnetic resonance imaging (MRI) performed also at the time of presentation to the emergency department demonstrated an area of hyperintensity in the right parietal lobe adjacent to the Sylvian fissure (right middle cerebral artery territory) consistent with clinical findings, a right PPTA and diffuse narrowing of visualized part of the right vertebral artery, possibly hypoplastic (Fig. 1).
(A) axial 3D-TOF MRI showing 'crescent sign' or dissection of left vertebral artery. (B) Sagittal highlight of major intracranial vessels and associated PPTA.
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Tesla demonstrated crescent sign in left vertebral artery indicating dissection (Fig. 2A), and PPTA between right ICA and distal basilar artery with normal diameter of both ICAs (Fig. 3).