Abstract
A 39-year-old woman with migraines without auras since adolescence presented with a sudden and severe left-sided headache with homonymous visual field impairment. 1.5T-MRI revealed an acute cerebral infarction in the left posterior cerebral artery (PCA) territories. Cerebral MRA and conventional angiography showed a dilated left PCA at the P2 segment but failed to delineate the intimal flap. However, 3T-MRA revealed an intimal flap clearly separating the lumen at the dilated P2 segment of the left PCA, and thus, dissection was confirmed. 3T-MRI seems superior to the more widely used 1.5T scanner and catheter arteriography for detecting the intimal flap of relatively small artery dissections. Cerebral artery dissection goes through dynamic morphologic changes, and thus, serial vascular imaging is necessary for evaluation. 3T-MRI is suitable for such high-resolution imaging in a non-invasive manner.
