Abstract
We report two cases of brain infarction due to basilar artery dissection. The first case was a 41-year-old woman who suddenly suffered from headache, visual loss, and loss of consciousness when she played badminton. Diffusion weighted brain MRI revealed high intensity in the left cerebellum and left occipital lobe. An intramural hematoma in the basilar artery was observed on T1 weighted imaging. Left vertebral angiography showed stenosis in the left vertebral artery which progressed to occlusion in 3 weeks. The second case was a 74-year-old woman who developed sensory disturbance on the right side after headache. Brain MRI revealed high intensity on T2 and diffusion weighted images in part of the left thalamus and occipital lobe. An intimal flap was also evident in the basilar artery. Although left occipital artery occlusion was found by conventional angiography, the basilar, artery was normal. The patients' symptoms and signs improved gradually resulting in a benign clinical course. It is suggested that MRI is a useful procedure for the detection of basilar artery dissection. There is a subgroup of basilar artery dissection presenting brain infarction with a good clinical recovery. The clinical outcome of such cases might be determined by the site of dissection, ventral or dorsal in the basilar artery.
