Case Reports in Radiology最新文献

{"title":"Carinal Squamous Cell Carcinoma Causing Progressive Central Airway Obstruction: CT, FDG PET/CT, Bronchoscopic Pre- and Post-Debulking, and Pathologic Correlation.","authors":"Saubhagya Dhakal, Govinda Adhikari, Ali Kanj Ahmad","doi":"10.1155/crra/3075194","DOIUrl":"10.1155/crra/3075194","url":null,"abstract":"<p><p>Primary tracheobronchial tumors are rare and are frequently diagnosed late because their presenting symptoms are nonspecific and may mimic more common respiratory conditions. We report a case of a 74-year-old man with a significant smoking history who presented with progressive dyspnea, cough, hemoptysis, and stridor, initially treated with multiple courses of antibiotics and corticosteroids, without improvement. Chest radiography was reportedly normal, but a contrast-enhanced CT demonstrated an endoluminal soft tissue mass centered at the distal trachea/carina with extension into the bilateral mainstem bronchi, causing near-complete obstruction of the left mainstem bronchus and moderate-to-severe narrowing of the right mainstem bronchus. Coronal FDG PET/CT demonstrated intense metabolic activity centered at the carina. Predebulking bronchoscopy confirmed a verrucous fungating carinal mass causing severe central airway compromise, whereas postdebulking bronchoscopy showed marked restoration of airway patency. Histopathologic evaluation established squamous cell carcinoma. This case highlights the diagnostic limitations of chest radiography and the essential role of CT, FDG PET/CT, and bronchoscopy in evaluating malignant central airway obstruction.</p>","PeriodicalId":30326,"journal":{"name":"Case Reports in Radiology","volume":"2026 ","pages":"3075194"},"PeriodicalIF":0.0,"publicationDate":"2026-08-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13443115/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148686255","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Endovascular Treatment of an Iatrogenic Inferior Mesenteric Arteriovenous Fistula Presenting as Massive Lower Gastrointestinal Hemorrhage: A Case Report.","authors":"Maria Mihailescu, Clayton W Commander, Robert Dixon, Nicole A Keefe","doi":"10.1155/crra/3779245","DOIUrl":"10.1155/crra/3779245","url":null,"abstract":"<p><p>Inferior mesenteric artery arteriovenous fistulae are rare, acquired connections between arterial and venous systems associated with a range of symptoms, from abdominal pain to life-threatening lower gastrointestinal hemorrhage. We report an iatrogenic inferior mesenteric artery arteriovenous fistula in a 30-year-old female, presenting with massive hematochezia 1 month after a left hemicolectomy. Angiography demonstrated a high-flow vascular connection between the inferior mesenteric artery and rectal veins, which was treated with n-butyl-2-cyanoacrylate mixed with ethiodized oil for arteriovenous connection occlusion followed by coil embolization of the feeding arteries. Follow-up imaging at 8 months showed no recanalization of the fistula, and she remains asymptomatic 4 years later. Iatrogenic inferior mesenteric artery arteriovenous fistulae, though rare, should be considered after colorectal surgery as a possible cause of recurrent lower gastrointestinal hemorrhage, even within weeks of the operation; dilated mesenteric varices and premature venous filling on the arterial phase are key CT findings. Endovascular management targeting the arteriovenous communication and feeding arteries can achieve durable occlusion in these high-flow fistulae.</p>","PeriodicalId":30326,"journal":{"name":"Case Reports in Radiology","volume":"2026 ","pages":"3779245"},"PeriodicalIF":0.0,"publicationDate":"2026-07-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13389808/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148563058","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Solitary Brain Metastasis From Hepatocellular Carcinoma Masquerading as Acute Ischaemic Stroke: Radiological Diagnosis and Clinical Implications.","authors":"Suzana Lukoo, James Sumawe, Bitesigilwe Mbelwa, Al Karim Kazema, Furaha Malecela, Masanja Singu, Francis Zerd, Jesse Kashabano, Henry Humba, Abel Makubi","doi":"10.1155/crra/5706773","DOIUrl":"10.1155/crra/5706773","url":null,"abstract":"<p><strong>Background: </strong>Brain metastases from hepatocellular carcinoma (HCC) are rare, with a reported incidence of approximately 0.2%-2.2% of cases. Although uncommon, they may present with acute focal neurological deficits that closely mimic acute cerebrovascular events, posing significant diagnostic challenges in emergency settings where stroke pathways are routinely prioritised. Failure to recognise an underlying structural lesion in this context may lead to inappropriate management and delayed definitive treatment.</p><p><strong>Case presentation: </strong>A 66-year-old man with chronic hepatitis B infection and biopsy-confirmed HCC (Barcelona Clinic Liver Cancer Stage B; serum alpha-fetoprotein 1000 ng/mL) presented with sudden-onset right-sided weakness, expressive aphasia and facial deviation approximately 4 weeks after initial HCC diagnosis. Noncontrast computed tomography (CT) of the brain demonstrated a hypodense intra-axial lesion in the left frontal lobe with surrounding vasogenic oedema. Because the atypical CT appearance and subsequent heterogeneous contrast enhancement raised suspicion for a neoplastic aetiology, magnetic resonance imaging (MRI) was performed; this revealed a solitary left frontal mass with avid enhancement and facilitated diffusion on diffusion-weighted imaging, which definitively ruled out acute ischaemic stroke. Gradient echo sequences also demonstrated blooming artefact consistent with intralesional haemorrhage. In the context of known HCC, the imaging findings were consistent with a solitary haemorrhagic brain metastasis presenting as a stroke mimic. The patient was discussed at a multidisciplinary tumour board and subsequently transitioned to palliative care owing to advanced systemic disease and poor functional status.</p><p><strong>Conclusion: </strong>Solitary brain metastasis from HCC should be considered in the differential diagnosis of patients presenting with acute focal neurological deficits, particularly when initial CT findings are atypical for ischaemic infarction or when a known primary malignancy is present. Early contrast-enhanced MRI, including diffusion-weighted sequences, is essential for accurate differentiation of stroke mimics and for guiding timely, appropriate clinical management.</p>","PeriodicalId":30326,"journal":{"name":"Case Reports in Radiology","volume":"2026 ","pages":"5706773"},"PeriodicalIF":0.0,"publicationDate":"2026-07-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13389434/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148563102","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Primary Malignant Pericardial Epithelioid Mesothelioma Presenting as Cardiac Tamponade: A Case Report With Multimodality Imaging and Radiologic-Pathologic Correlation.","authors":"Saubhagya Dhakal, Paulo Savoia, Nikahat Yasmine, Subhashis Mitra","doi":"10.1155/crra/7217020","DOIUrl":"10.1155/crra/7217020","url":null,"abstract":"<p><p>Primary malignant pericardial mesothelioma is an exceptionally rare and aggressive malignancy that frequently presents with nonspecific cardiopulmonary symptoms, recurrent pericardial effusion, constrictive physiology, or cardiac tamponade. Early diagnosis is challenging because an infiltrative pericardial tumor may remain occult on initial imaging studies performed for acute cardiopulmonary evaluation. A 67-year-old woman presented with chest discomfort and shortness of breath. CT pulmonary angiography and thoracic aortic computed tomography angiography (CTA) were performed to evaluate for pulmonary embolism and acute aortic pathology. The examinations were negative for pulmonary embolism and acute aortic abnormality; however, they revealed a large mildly hyperattenuating circumferential pericardial effusion measuring approximately 35 HU, concerning for complex mixed hemorrhagic and serous fluid with tamponade physiology. No discrete enhancing pericardial mass was confidently identified on the initial CTA examination. Transthoracic echocardiography confirmed a large pericardial effusion with tamponade physiology. Pericardiocentesis removed approximately 600 cc of fluid, with cytologic analysis nondiagnostic for malignant cells. The patient returned approximately 2 weeks later with progressive dyspnea. Cardiac MRI demonstrated an extensive heterogeneously enhancing infiltrative anterior pericardial mass extending toward the great vessels and left atrial region. FDG PET/CT showed an intensely FDG-avid infiltrative pericardial mass without distant metastatic disease or FDG-avid lymphadenopathy. Thoracoscopy and pericardial biopsy confirmed epithelioid mesothelioma. Immunohistochemistry revealed positivity for CK7, calretinin, CK5/6, and WT1 and negativity for claudin-4 and TTF-1. The patient was treated with carboplatin and pemetrexed, with planned radiation therapy. This case highlights that primary malignant pericardial mesothelioma may initially present as complex hemorrhagic pericardial effusion with tamponade physiology, with infiltrative tumor occult on nondedicated acute CTA examinations. Persistent or recurrent symptoms following drainage should prompt further evaluation with cardiac MRI and PET/CT for tissue characterization, staging, and biopsy planning.</p>","PeriodicalId":30326,"journal":{"name":"Case Reports in Radiology","volume":"2026 ","pages":"7217020"},"PeriodicalIF":0.0,"publicationDate":"2026-07-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13357981/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148438147","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Unmasking Coronary Microvascular Dysfunction in Hypertrophic Cardiomyopathy: Multimodality Imaging With Stress Cardiac MRI and Coronary CT Angiography.","authors":"Furkan Ufuk","doi":"10.1155/crra/6238939","DOIUrl":"10.1155/crra/6238939","url":null,"abstract":"<p><p>Coronary microvascular dysfunction (CMD) is a hallmark feature in hypertrophic cardiomyopathy (HCM), linked to significant clinical challenges including myocardial ischemia, fibrosis, and an elevated risk of heart failure and sudden cardiac death. In this case, a 21-year-old female presented with intermittent lower extremity edema, exertional dyspnea, and persistent fatigue. Imaging studies were pivotal in identifying the underlying CMD and confirming the HCM diagnosis. Transthoracic echocardiography revealed mild left ventricular hypertrophy with hyperdynamic function, reduced global longitudinal strain, and mildly increased LVOT gradients. Cardiac magnetic resonance imaging (CMR) provided more definitive findings: severe asymmetrical left ventricular hypertrophy, most pronounced in the apical inferoseptal wall, alongside subendocardial perfusion defects identified during regadenoson stress perfusion imaging. These perfusion abnormalities involved multiple myocardial segments and did not conform to a single epicardial coronary artery distribution, supporting a microvascular pattern of ischemia and strongly implicating CMD as the underlying cause of myocardial ischemia. The absence of late gadolinium enhancement, coupled with elevated native T1 and extracellular volume values, suggested early interstitial expansion without extensive fibrosis. Coronary computed tomography angiography confirmed the absence of significant epicardial coronary artery disease, further substantiating that the ischemia was driven by microvascular dysfunction rather than large-vessel obstruction. Structural abnormalities in the coronary microvasculature, such as intimal and medial hyperplasia, reduced lumen size, and impaired vasodilatory capacity, were likely contributors to the CMD observed in this patient. In summary, this case highlights the crucial role of advanced imaging techniques, such as CMR stress perfusion and T1 mapping, in diagnosing CMD within the context of HCM. These findings underscore the need for tailored management strategies targeting CMD to mitigate its impact on clinical outcomes in HCM patients.</p>","PeriodicalId":30326,"journal":{"name":"Case Reports in Radiology","volume":"2026 ","pages":"6238939"},"PeriodicalIF":0.0,"publicationDate":"2026-07-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13343473/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148413179","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Postpartum Retroperitoneal Fibrosis With IVC Obstruction: A Case Report.","authors":"Roy Clark Basiimwa, Samuel Bugeza, Rita Nassanga, Dell P Dunn","doi":"10.1155/crra/6285423","DOIUrl":"10.1155/crra/6285423","url":null,"abstract":"<p><p>Retroperitoneal fibrosis (RPF) is a rare fibroinflammatory condition producing inflammatory masses in the retroperitoneum that can obstruct retroperitoneal structures, including vessels and ureters. RPF typically presents in middle-aged men and may be associated with IgG-4-related disease (IgG-4 RD). This report describes a 34-year-old woman who presented 6 months postpartum with left leg swelling and lower abdominal pain. Contrast-enhanced CT revealed a homogenous retroperitoneal soft-tissue mass encasing the aorta and iliac arteries, with inferior vena cava (IVC) obstruction and collateral venous return through extensive pelvic varices. MRI findings included hypointensity on T2-weighted imaging and restricted diffusion. Management with thrombolytics and steroids resulted in recanalization of the IVC, though persistent hydronephrosis required nephrostomy and further urological intervention. The presentation of RPF in a young woman is unusual, and we theorize that immune system reactivation following the relative immunosuppression during pregnancy may have precipitated the condition. The case illustrates one of several immunologic factors associated with RPF.</p>","PeriodicalId":30326,"journal":{"name":"Case Reports in Radiology","volume":"2026 ","pages":"6285423"},"PeriodicalIF":0.0,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13319899/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148370047","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Recurrent PRES in a Patient With Cyclic Vomiting Syndrome.","authors":"Arman Mahmood, Allen Mao, Ibrahim Sacit Tuna","doi":"10.1155/crra/3914162","DOIUrl":"10.1155/crra/3914162","url":null,"abstract":"<p><p>Cyclic vomiting syndrome (CVS) is a functional gastrointestinal disorder defined by recurrent, stereotyped episodes of severe nausea and vomiting separated by symptom-free intervals, and it is frequently accompanied by autonomic dysregulation and, in some patients, hypertension. Posterior reversible encephalopathy syndrome (PRES) is a clinicoradiologic syndrome commonly linked to acute hypertension and characterized by vasogenic edema on neuroimaging. We describe a 16-year-old female with a long-standing, criteria-based diagnosis of CVS and chronic, recurrent hypertension who developed MRI-confirmed PRES during a period of sustained postoperative hypertension. She had a prior MRI-confirmed episode of PRES in 2012, with documented radiologic reversibility on follow-up imaging. Neuroimaging during the index admission demonstrated vasogenic edema in the parieto-occipital lobes and cerebellar vermis. Secondary causes of hypertension, including pheochromocytoma, primary aldosteronism, thyroid disease, renal and renovascular disease, and Cushing syndrome, were systematically excluded, and the episode was considered most likely related to her hypertension. We discuss CVS-related autonomic dysregulation as a possible contributor, while recognizing hypertension as the immediate driver of PRES in this case. Prompt antihypertensive therapy and seizure prophylaxis were followed by clinical and radiologic improvement. This case highlights the value of recognizing recurrent hypertensive PRES in adolescents with CVS and of carefully excluding alternative etiologies.</p>","PeriodicalId":30326,"journal":{"name":"Case Reports in Radiology","volume":"2026 ","pages":"3914162"},"PeriodicalIF":0.0,"publicationDate":"2026-06-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13305317/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148346507","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Diffuse Intraductal Breast Papillomatosis in a 34-Year-Old Female With Maffucci Syndrome: A Case Report.","authors":"Eren Sakarcan, Jeanette Fulton","doi":"10.1155/crra/7030550","DOIUrl":"10.1155/crra/7030550","url":null,"abstract":"<p><strong>Purpose: </strong>This report aims to raise clinical awareness of a rare case of Maffucci syndrome in a 34-year-old female presenting with diffuse intraductal breast papillomatosis. It further explores a possible hypothesis-generating pathogenic association between Maffucci syndrome and a specific subtype of papillary breast neoplasia in the context of shared molecular pathways involved in disease pathogenesis.</p><p><strong>Introduction: </strong>Maffucci syndrome is a rare, congenital, nonhereditary disorder characterized by enchondromas, hemangiomas, and skeletal deformities, typically presenting in early childhood. Since its initial description in 1881, fewer than 300 cases have been reported, with an estimated prevalence of < 1 in 27 million. Somatic mutations in IDH1 and IDH2 are key drivers of Maffucci syndrome and are also implicated in malignancies such as gliomas, chondrosarcomas, intrahepatic cholangiocarcinoma, and acute myeloid leukemia. Most relevant to this case, tall cell carcinoma with reversed polarity (TCCRP)-a rare subtype of papillary breast carcinoma-is characteristically associated with hotspot IDH2 R172 mutations, a molecular feature otherwise uncommon in both breast carcinomas and Maffucci syndrome. Only one documented case of an IDH1-mutated solid papillary carcinoma with reversed polarity (SPCRP) exists in the current literature.</p><p><strong>Case description: </strong>The patient is a 34-year-old female with Maffucci syndrome, diagnosed in childhood via clinical and radiographic evaluation, with a history of skeletal and vascular complications, including primary chondrosarcomas of the left scapula, right distal patella, and right proximal tibia. She initially presented in 2016 with left-sided hemorrhagic nipple discharge, prompting serial imaging and biopsies that identified recurrent intraductal papillary lesions, consistently benign on core needle biopsy and surgical excision. A right-sided lesion was excised in 2022, followed by two left-sided lesions resected in 2023 and 2024. Mammography in November 2024 revealed three nodular lesions in the left lateral breast, characterized as complex cystic masses, with core needle biopsy confirming benign intraductal papillomas without atypia. Although subsequent imaging demonstrated stability of these lesions on follow-up ultrasound in June 2025, the longitudinal course illustrates a recurrent pattern of intraductal papillary lesion development over time.</p><p><strong>Conclusions and importance: </strong>This case raises the possibility of an association between Maffucci syndrome and recurrent papillary breast lesions. In the absence of molecular confirmation, this relationship remains speculative and should be regarded as hypothesis generating, underscoring the need for further investigation with genetic and immunohistochemical correlation rather than changes to established breast cancer screening guidelines.</p>","PeriodicalId":30326,"journal":{"name":"Case Reports in Radiology","volume":"2026 ","pages":"7030550"},"PeriodicalIF":0.0,"publicationDate":"2026-06-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13284830/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148309908","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Hypoglycemic Encephalopathy Caused by Insulinoma With Reversible High Signals in the White Matter on Diffusion-Weighted MRI: A Case Report.","authors":"Taira Shiratori, Iichiro Osawa, Wataru Watanabe, Keita Nagawa, Koichiro Matsuura, Shinji Kakemoto, Morihiro Higashi, Eito Kozawa","doi":"10.1155/crra/7322838","DOIUrl":"10.1155/crra/7322838","url":null,"abstract":"<p><p>Hypoglycemic encephalopathy can result in reversible, and sometimes irreversible, lesions within the brain that need prompt recognition and treatment. The disease is relatively uncommon, but radiologists must keep in mind the rare radiologic findings of this disease. Although the most common cause is insulin, insulinoma is a rare etiology, and hypoglycemia is often misdiagnosed as epilepsy. A 66-year-old man presented with recurrent involuntary movements and impaired consciousness with neuropsychiatric symptoms without a history of antidiabetic therapy. Initial blood glucose was critically low at 29 mg/dL. Diffusion-weighted imaging (DWI) revealed reversible high signals in the white matter, involving the bilateral posterior limbs of the internal capsule, corona radiata, cerebral peduncle, and splenium of the corpus callosum. A fasting test and contrast-enhanced computed tomography confirmed the diagnosis of insulinoma. Intravenous glucose was administered immediately, resulting in rapid clinical improvement. Laparoscopic distal pancreatectomy was subsequently performed. Clinical symptoms resolved completely within 1 day of glucose administration. Follow-up DWI performed 2 months after onset demonstrated complete resolution of all white matter hyperintensities without recurrence. The patient reported feeling well without recurrence of the symptoms. We report a case of hypoglycemic encephalopathy caused by insulinoma with reversible high signals in the white matter on DWI, presenting with neuropsychiatric symptoms mimicking epilepsy. We also discuss findings of magnetic resonance imaging in hypoglycemic encephalopathy with emphasis on the time course of the findings.</p>","PeriodicalId":30326,"journal":{"name":"Case Reports in Radiology","volume":"2026 ","pages":"7322838"},"PeriodicalIF":0.0,"publicationDate":"2026-06-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13261534/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148253646","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Vertebral Artery Pseudoaneurysm in a Single-Vessel Posterior Circulation With Chronic Contralateral Occlusion and Recent Methamphetamine Use.","authors":"Daniel Reyes, Daniel Gridley","doi":"10.1155/crra/5898856","DOIUrl":"10.1155/crra/5898856","url":null,"abstract":"<p><p>Bilateral vertebral artery disease presents a critical risk for posterior circulation stroke due to impaired collateral flow. This report details an adult presenting with acute neck pain and visual disturbances. Computed tomography (CT) angiography revealed left vertebral artery dissection at the C2 level with a 0.5 cm dissecting pseudoaneurysm and complete occlusion of the right vertebral artery. Magnetic resonance imaging (MRI) demonstrated no acute infarction. Symptoms improved with conservative management, including antiplatelet therapy. The case highlights the importance of recognizing high-risk bilateral vertebral artery pathology, understanding its imaging features, and considering substance abuse as a risk factor for arterial dissection. This case is notable for V3 dissecting pseudoaneurysm in the only functional vertebral artery in the setting of chronic contralateral occlusion and recent methamphetamine use, successfully managed conservatively.</p>","PeriodicalId":30326,"journal":{"name":"Case Reports in Radiology","volume":"2026 ","pages":"5898856"},"PeriodicalIF":0.0,"publicationDate":"2026-06-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13247984/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148219960","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}