Figure 5.

Unsubtracted (a) and digital subtraction angiography (b) images of a 65-year-old female with left middle cerebral artery stroke showing dissection at the left internal carotid artery (ICA) distal cervical segment because of friction from the 8-Fr balloon-guiding catheter on the intimal surface of the vessel that caused no flow disturbance in the parent vessel. T₁ weighted axial fat saturated MRI (c) showing vessel stenosis because of dissection at the left ICA (arrow), which was noticed during the follow-up for the previous silent dissection. As dissection occurred initially during the endovascular intervention and stayed stable without progressing to occlusion, we did not further intervene.