PMC4673856_01
Axial 1.5 T MR, CT and CTA images demonstrate bilateral SCA infarct and left vertebral artery dissection. a-d Sequential axial FLAIR MR images demonstrate bilateral cerebellar hemisphere hyperintensity superiorly with relative sparing inferiorly (not shown) and involvement of the colliculi in the midbrain and the superior cerebellar peduncles. e-h Sequential axial diffusion MR images demonstrate restricted diffusion in both cerebellar hemispheres in the same distribution of the FLAIR images. i-l Sequential axial non-contrast CT images demonstrate patchy areas of hypoattenuation bilaterally in the superior aspects of the cerebellar hemispheres. m-n Select axial CTA images demonstrate decreased caliber of left vertebral artery with arterial lumen filling defect (arrow). As well a filling defect is present in the basilar terminus extending to the P1 segment of the left PCA (arrowhead). MR magnetic resonance, FLAIR fluid-attenuated inversion recovery, CT computer tomography, CTA computer tomography angiography, SCA superior cerebellar artery, PCA posterior cerebral artery
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Fig1
His initial CT scan was inconclusive but a subsequent MRI later the same day demonstrated extensive acute bilateral cerebellar infarcts with some involvement of the midbrain colliculi and superior cerebellar peduncles (Fig. 1). Bilateral SCA territory infarcts were indicated by patchy areas of hypoattenuation within the bilateral cerebellar hemispheres as well as the inferior right and bilateral superior cerebellar lobes (Fig. 1).