Fig. 1

Diagnostic findings of bilateral ICA dissection and TOCU findings of right ICA dissection. a: Axial diffusion-weighted imaging showing multiple hyperintense signals in the right middle cerebral artery territory. b: Intracranial MRA showing no occlusion or stenoses in the right ICA territory. Multifocal segmental left ICA narrowing indicating previous arterial dissection (arrowheads). c: Cervical CTA showing right extracranial ICA stenosis (arrow) and left ICA narrowing from the extracranial ICA (arrows), accompanied by the bilateral elongated styloid process (arrowheads) close to each side of ICA. d and e: Cervical MRI showing intramural hematoma in T1-weighted imaging d and double-lumen in T2-weighted imaging e. f: Longitudinal view of TOCU showed right ICA stenosis with a thrombosed pseudolumen due to artery dissection (arrowheads). The styloid process (arrow) is spatially close to the dissection site accompanied by an acoustic shadow. g: Right ICA stenosis with a thrombosed pseudolumen decreased for 4 months of follow-up