Figure 3.

An embolism-related occlusion (EMB-O) case with vessel wall MRI taken on the third day after stroke onset. A 72-year-old man had an acute infarction in the posterior inferior cerebellar artery territory, due to right vertebral artery occlusion, but did not undertake endovascular revascularization treatment (ERT). His stroke etiology was cardioembolism by thorough evaluations. (A) Contrast-enhanced MR angiography shows an occlusion in the right vertebral artery. (B) Gradient echo images taken on admission, included in the baseline routine MRI, show a susceptibility vessel sign. Proton density-weighted (C) and T1-weighted (D) imaging does not show a specific finding but an occlusion is suggested since a signal void, as seen in normal arterial lumen, is absent. (E) T2-weighted imaging reveals an intact vessel wall but the lumen shows slightly higher signal intensity compared to a normal contralateral vertebral artery. (F) Thrombus in the occluded vessel appears to be stained by contrast and shows high signal intensity. The blue arrow indicates the vertebral artery occluded due to an embolism. The yellow arrow indicates the contralateral normal vertebral artery.