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FIGURE LEGENDS
Figure 1: Arterial phase, contrast-enhanced CT scan (cervical
axial sections) showing extension of the aortic dissection to the
supra-aortic trunks. The right common carotid artery and the right
internal carotid artery are not opacified. The left common artery is
dissected and thrombosed with a left internal carotid artery opacified
probably through retrograde collateral flow. Both vertebral arteries are
patent.
Figure 2. Brain Magnetic Resonance Imaging, b1000 diffusion
sequence signal revealing a limited recent cortical ischemic injury
(white arrow) in the right internal carotid territory. The remaining
brain parenchyma is viable.
Figure 3. A) Contrast-enhanced CT scan showing type A acute
aortic dissection. The right coronary artery arises from the false lumen
with a dynamic obstruction of the left main stem. B) At the
abdominal level, the splanchnic arteries arise from the true lumen with
no sign of mesenteric ischemia.
Figure 4. A) Non-contrast enhanced MR Angiography (ARM
3D TOF) showing integrity of the polygon of Willis and its perfusion
through B) the vertebral arteries, allowing the maintenance of
an antegrade flow in both Sylvian arteries.
VIDEO LEGENDS
Video 1 . Contrast-enhanced CT scan from the abdominal aorta to
the supra-aortic vessels showing type A aortic dissection and its
extensions to the various arterial branches. The right common carotid
and right internal carotid arteries are not opacified. The left common
carotid artery is dissected and thrombosed. The left internal carotid
artery is partially opacified retrogradely. Both vertebral axes are
patent.
Video 2. 3D TOF Magnetic Resonance Imaging angiogram showing no
visibility of the right carotid artery within the carotid canal. On the
other hand, a complete anastomotic arterial circle of the base was
identified, the blood flow towards its anterior portion being provided
by vertebral arteries. The right middle cerebral artery was less intense
in signal due to the underlying cervical involvement.