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A 71 year old woman presented with vertigo, nausea and vomiting. Examination showed a left sided Horner's, left facial numbness; numbness over the right body; left sided ataxia, slurred speech, and weakness of the left soft palate.
(Left) Dissection protocol MRI of the upper neck - note the bright signal in the region of the left vertebral artery that indicates acute blood (i.e., dissection of the vertebral artery); (Right) Intracranial MRA. Note the absence of the left vertebral. Also notes several other areas of intrinsic intracranial vessel narrowing.
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