PMC3046004_01
A) T2-weighted MRI (Magnetom Sonata A.G., Siemens, Erlangen, Germany, TR/TE = 4000/123, ETL = 11) showed a right thalamic infarction in our patient. B), C) Angiograms showed mild wall irregularity (arrows) at the C1-2 level and the duplicated right vertebral artery (VA). D) The lower branch is compressed by head rotation to the left. E), F) CT angiograms showed normal courses of the left VA and the upper branch of the right VA (arrows). The lower branch ran between the C1 and C2 vertebrae (arrowhead). Arteries (pseudocolored red); those under other structures (light red).
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Nine months later, dizziness and unconsciousness occurred without head rotation, and were found to be caused by an infarct in the right thalamus (Fig. 1A). No other abnormalities, including dissection, were evident (Fig. 1B-D). Three-dimensional CT angiography, a method that clearly visualizes both vascular lesions and surrounding structures, showed that the lower branch of the VA ran between the C1 and C2 vertebrae (Fig. 1F).