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.
Selim M. 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