Usefulness of combining CISS and digital subtraction angiography in diagnosis of isolated posterior inferior cerebellar artery dissection

A 63-year-old man was admitted to our stroke center with brain infarction in the left posterior inferior cerebellar artery (PICA) territory. The initial MRI showed no findings suggestive of arterial dissection, and post-discharge MRI showed no temporal changes. Digital subtraction angiography (DSA)...

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Bibliographic Details
Published in:Journal of stroke and cerebrovascular diseases 2023-06, Vol.32 (6), p.107087, Article 107087
Main Authors: Hashimoto, Go, Kuwashiro, Takahiro, Tagawa, Naoki, Mizoguchi, Tadataka, Mori, Kota, Sugimori, Hiroshi, Yasaka, Masahiro, Okada, Yasushi
Format: Article
Language:English
Subjects:
Aftercare
Angiography, Digital Subtraction
Brain infarction
Brain Infarction - pathology
Cerebellum - blood supply
CISS
Digital subtraction angiography
Humans
Intramural hematoma
Isolated posterior inferior cerebellar artery dissection
Male
Middle Aged
Patient Discharge
Vertebral Artery - pathology
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Description
Summary:A 63-year-old man was admitted to our stroke center with brain infarction in the left posterior inferior cerebellar artery (PICA) territory. The initial MRI showed no findings suggestive of arterial dissection, and post-discharge MRI showed no temporal changes. Digital subtraction angiography (DSA) revealed vasodilation of the proximal portion of the PICA but it was uncertain whether dissection was present. Discrepancy between the outer contour seen on constructive interference in steady state (CISS) MRI and the inner contour seen on DSA suggested the presence of intramural hematoma. The patient was diagnosed with brain infarction caused by isolated PICA dissection (iPICAD). Imaging evaluation of combined CISS and DSA may be particularly useful for identification of small iPICAD lesions.
ISSN:1052-3057
1532-8511
DOI:10.1016/j.jstrokecerebrovasdis.2023.107087