혈관조영술 및 고해상도 뇌혈관벽 MRI를 이용하여 진단된 단일 관통동맥으로 발생한 양측 방정중 중뇌경색
Roles of Diagnostic Cerebral Angiography and High-resolution Vessel-wall Imaging in Evaluating Basilar Artery Perforators: A Case of Bilateral Midbrain Infarction
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초록
Bilateral midbrain infarctions are often associated with basilar artery (BA) steno-occlusion, but identifying the stroke etiology is difficult when large vessels appear normal. We present a 90-year-old female with wall-eyed bilateral internuclear ophthalmoplegia. Initial diffusionweighted imaging showed subtle bilateral midbrain lesions, while computed tomography angiography produced normal findings. Vessel-wall imaging and diagnostic angiography identified an abnormal single perforator from the distal BA supplying both sides. This case highlights the importance of these techniques in detecting perforator abnormalities in stroke with unclear etiology.
Abstract
Bilateral midbrain infarctions are often associated with basilar artery (BA) steno-occlusion, but identifying the stroke etiology is difficult when large vessels appear normal. We present a 90-year-old female with wall-eyed bilateral internuclear ophthalmoplegia. Initial diffusionweighted imaging showed subtle bilateral midbrain lesions, while computed tomography angiography produced normal findings. Vessel-wall imaging and diagnostic angiography identified an abnormal single perforator from the distal BA supplying both sides. This case highlights the importance of these techniques in detecting perforator abnormalities in stroke with unclear etiology.