Fig. 5

Possible devastating outcomes of untreated BCVIs. A 28-year-old man who had suffered a car accident. The sagittal MIP reconstruction (a) (3-mm thickness) shows a progressive tapering of the left internal carotid artery (arrowheads) that becomes occluded before the intracranial portion. Latero-lateral digital subtraction angiography image (b) shows exactly the same finding as MDCT (arrowheads) with no contrast material within the intracranial portion of left internal carotid artery. The patient showed no risk factors for BCVI and was neurologically asymptomatic at the time of MDCT. Anti-aggregation was not undertaken because of the presence of severe abdominal injuries and high bleeding risk. The axial DWI MR image (c) (b = 1,000) acquired 2 days later, after the onset of right hemiparesis and aphasia, shows a marked signal hyperintensity in the territory of the left mean cerebral artery representing acute infarction