MR imaging of intracranial vertebral artery occlusion

Magnetic resonance (MR) images of nine patients with intracranial vertebral artery occlusion (five proved, four presumed) have been reviewed. In two of nine, both vertebral arteries were occluded and in five of the nine, the basilar artery was also blocked. All occluded arteries showed absence of flow void and were clearly demonstrated as mildly hypo- approximately mildly hyperintense structures to brainstem parenchyma on the T1-weighted images. In two of five patients with basilar artery occlusion, retrograde filling of the distal basilar artery was detected. Thus, MR imaging, in particular the T1-weighted image, is a pertinent diagnostic modality for evaluating intracranial vertebral artery occlusion. Angiography does not seem to be required for confirmation.