PMC6438116_01
Foraminal infiltration of the cervical spine. The tip of the spinal needle is located in the transverse foramen. Extravascular diffusion of the contrast agent, no enhancement of the vertebral artery appear (washing).
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This procedure was performed according to the current medical guidelines (Fig. 1).
Diffusion MRI (A) with ADC mapping (B) sequences: in the basilar and posterior cerebral artery territories, multiple foci of diffusion restriction (hyperintensity) with a dropped bilateral ADC signal (hypointensity) are seen
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CT angiography including the supra-aortic trunks was normal, but MRI showed acute bilateral ischaemic lesions in the thalamic nuclei, microlesions in the two posterior cerebral territories and bilateral lesions in the brainstem and cerebellar hemispheres (Fig. 2).
FLAIR sequence on MRI showing hyperintense foci on bilateral thalamic and occipital lobes (posterior cerebral artery territories)
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These lesions as well as perilesional oedema were noted on the FLAIR sequence (Figs. 3 and 4).
Angio-MRI showing no rupture of the blood-brain barrier. The vertebral arteries, the basilar trunk and Willis polygon are free of occlusion
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These lesions as well as perilesional oedema were noted on the FLAIR sequence (Figs. 3 and 4).