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FIG 2. Patient 6: 13-year-old girl with carotid occlusion associated with basal ganglia infarction. This case illustrates the insensitivity of MR angiography to distal carotid occlusion when flow through the circle of Willis is intact. By MR angiography, the right ICA was patent and the MCA was small.
A, Proton density–weighted image shows infarct of the right putamen.
B, Axial MIP from 3D TOF MR angiography (0.5 T) shows small-caliber right MCA and A1 segments, suggesting disease in both vessels. The right ICA appears patent but was actually occluded at DSA.
C, DSA shows abrupt occlusion of a small-caliber ICA at the level of the ophthalmic artery. The MCA and A1 segments were normal with injection of the left ICA.
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