J Korean Neurol Assoc.
2025 May;43(2):109-113. 10.17340/jkna.2024.0068.
Roles of Diagnostic Cerebral Angiography and High-resolution Vessel-wall Imaging in Evaluating Basilar Artery Perforators: A Case of Bilateral Midbrain Infarction
- Affiliations
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- 1Department of Neurology, Korea University Guro Hospital, Korea University College of Medicine, Seoul, Korea
- 2Department of Radiology, Korea University Guro Hospital, Korea University College of Medicine, Seoul, Korea
- KMID: 2567419
- DOI: http://doi.org/10.17340/jkna.2024.0068
Abstract
- Bilateral midbrain infarctions are often associated with basilar artery (BA) steno-occlusion, but identifying the stroke etiology is difficult when large vessels appear normal. We present a 90-year-old female with wall-eyed bilateral internuclear ophthalmoplegia. Initial diffusion-weighted imaging showed subtle bilateral midbrain lesions, while computed tomography angiography produced normal findings. Vessel-wall imaging and diagnostic angiography identified an abnormal single perforator from the distal BA supplying both sides. This case highlights the importance of these techniques in detecting perforator abnormalities in stroke with unclear etiology.
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