The Agony of Choice: Diagnosis of Cervical Artery Dissection by Means of Duplexsonography or Magnetic Resonance Imaging?

626 ing about 100 kg had fallen against her head. The neurological examination was unrevealing except for a slight ptosis of the left eyelid and a mild holocranial diffuse headache. The initial ECD showed no abnormalities. However, due to the described severity of the trauma caused by the weight of the heavy cupboard and the left ptosis, cervical MRI with axial T1-fat-saturated sequences as well as MR angiography were performed. These revealed significant signal increase of the left common carotid artery in the fat-saturated sequences, whereas the MR angiography showed no abnormalities ( fig. 1 a, b). There was a visible extension of the signal increase into the internal carotid artery in follow-up MRIs, but the follow-up ECDs were unable to detect any flow or vessel wall abnormality.