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.