% strPathPics = Session("strPathPicsL") imgBg = strPathPics + Session("strMedia") %>
A 84 year-old man presented with a left visual field loss and change in personality.
(Top) Axial MRI Flair scans; (Bottom) Magnetic Resonance Angiography, intracranial circulation. In the brain images on the top, note the area of increased signal in the right occipital lobe (territory of the right posterior cerebral artery (PCA)) and the right temporal lobe (in the distribution of the inferior division of the right middle cerebral artery (MCA)). On the MRA, the right PCA is occluded (bottom right) and the right MCA is severely narrowed or occluded (bottom left - note that some flow is seen distally, either the lesion is severely stenotic or there is intact collateral circulation). In this case, the patient has primary disease of the intracranial circulation. This pattern is more common in African Americans and Orientals, as compared to Caucasians where atherosclerosis is often more prominent in the carotid and proximal vertebral arteries.
The Electronic Curriculum is copyrighted 1998, Case Western Reserve University School of Medicine.