Figure Legends
Figure 1. Neuroradiological findings at onset. (A) Plain CT scan
revealed hyper density along the right cingulate sulcus, consistent with
SAH. (B) MRI FLAIR images revealed hyperintensity involving the right
occipital lobe and bilateral basal ganglia. These changes represent
vasogenic edema due to PRES. (C) Magnetic resonance angiography (MRA)
showed segmental narrowing (yellow arrowheads) of the bilateral middle
and posterior cerebral arteries. (D) In right extracranial vertebral
artery at the C3/4 level, cervical MRA (3D Time-of-flight) showed vessel
contour abnormality (white arrowheads) and MSDE coronal (E) and axial
(F) images showed a periluminal rim (white arrow) indicative of an
intramural hematoma (IMH) suggesting a possible of dissection.
Figure 2. Neuroradiological findings three months after onset. (A) FLAIR
images revealed the disappearance of initial abnormal lesions, and (B,
C) MRA findings were normalized. MSDE coronal (D) and axial(E) showed
the disappearance of a periluminal rim (white arrow). Based on the
changes in findings over time, we diagnosed this lesion as vertebral
artery dissection.