MR-imaging of thrombus in extra- and intracranial arteries employing balanced fast-field echo MRI

Causes of stroke in young adults include a variety of disorders that are less frequently seen in older patients. We report the case of a young patient, who suffered recurrent mild embolic infarctions from a free-floating thrombus formation of the internal carotid artery bulb. During preoperative preparation, the thrombus dislodged and led to middle cerebral artery occlusion and major stroke. Both during preoperative work-up and after thrombus displacement balanced fast field echo sequences were able to demonstrate thrombus with a high signal-to-noise ratio and a superior delineation of thrombus and flowing blood. The high contrast between blood and thrombus helped to establish the diagnosis, to plan subsequent treatment strategies and to follow closely the clinical course. Further studies have to show whether this technique might help in thrombus characterization.