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. 2022 Feb 8;12(2):432. doi: 10.3390/diagnostics12020432

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© 2022 by the authors.

Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (https://creativecommons.org/licenses/by/4.0/).

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A representative case of vertebral artery dissection. A 57-year-old woman patient presented with severe headache. Cerebral angiography (A) and time-of-flight MRA (B) showing the only focal stenosis at the left V4 segment of the vertebral artery (yellow arrow). (C) The intimal flap sign (red arrow) presents as iso-signal intensity on proton-density high-resolution vessel wall imaging (HR-VWI). The double-lumen sign is also observed. (D,E) Periarterial enhancement (red arrowhead) on contrast-enhanced T1-weighted HR-VWI.