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Images in Neurology
September 2006

Vertebral Artery Susceptibility Sign as a Marker of Vertebral Thromboembolism on Magnetic Resonance Imaging

Arch Neurol. 2006;63(9):1330. doi:10.1001/archneur.63.9.1330

A number of studies1 have reported the use of gradient-echo T2*-weighted magnetic resonance imaging to assess the status of the middle cerebral arteries, describing the so-called middle cerebral artery susceptibility sign that represents an intraluminal clot from a thrombus or an embolus. Here we describe a 61-year-old man with history of hypertension, heavy alcohol use, and peripheral neuropathy who came to us with an acute onset of vertigo, nausea, and diaphoresis. He had a regular heart rate of 102 beats/min and blood pressure of 192/82 mm Hg. Neurological examination results were noted for horizontal nystagmus on left lateral gaze, tremulousness of the outstretched hands, dysmetric finger-nose-finger and slowed rapid alternating movements of the left hand, diminished deep tendon reflexes, profound peripheral neuropathy, wide-based stance and gait, and inability to tandem. He had no dysarthria, Horner syndrome, weakness, or hemisensory deficits. Ocular movements and visual fields were intact.

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