title: Hypoplasia or stenosis: Usefulness of high-resolution MRI.
abstract: BACKGROUND
  Hypoplastic basilar (BA) and vertebral arteries (VA) can cause posterior circulation infarctions. Distinction between hypoplastic and atherosclerotic BA can be difficult with usual angiographic methods (MR, CT or conventional angiographies), only showing arterial luminogram. High-resolution MRI (HRMRI) of the arterial wall is promising in identifying intracranial artery plaques.
  
  
  METHODS
  A 70-year-old man with vascular risk factors suddenly presented with vertigo. MRI showed no brain infarction. Contrast-enhanced MRA showed small and irregular BA lumen compatible with severe atherosclerotic stenosis. An associated persistent primitive trigeminal artery was noticed. HRMRI of the BA rectified the initial angiographic diagnosis by showing a normal vessel wall without any thickening that could suggest atherosclerotic plaque.
  
  
  CONCLUSIONS
  In the event of BA lumen narrowing, HRMRI may help distinguish between hypoplastic and atherosclerotic artery.
authors.affiliation: Department of neurology and stroke center, Versailles Mignot Hospital, 1, rue Richaud, 78000 Versailles, France. docteur.mariani@gmail.com
authors.forename: L L
authors.initials: LL
authors.lastname: Mariani
authors.forename: I
authors.initials: I
authors.lastname: Klein
authors.forename: Fernando
authors.initials: F
authors.lastname: Pico
mesh_terms: D000368:Aged; D000959:Antihypertensive Agents / Q000627:therapeutic use; D050197:Atherosclerosis / Q000473:pathology; D001488:Basilar Artery / Q000002:abnormalities* / Q000473:pathology; D003937:Diagnosis, Differential; D006801:Humans; D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors / Q000627:therapeutic use; D018810:Magnetic Resonance Angiography; D008279:Magnetic Resonance Imaging; D008297:Male; D010975:Platelet Aggregation Inhibitors / Q000627:therapeutic use; D014057:Tomography, X-Ray Computed; D014715:Vertebrobasilar Insufficiency / Q000175:diagnosis* / Q000188:drug therapy / Q000473:pathology; D014717:Vertigo / Q000209:etiology
chemical_list: D000959:Antihypertensive Agents; D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors; D010975:Platelet Aggregation Inhibitors