case_images: PMC11828927_01
case_images: 3D computed tomography angiogram (CTA) and digital subtraction angiography (DSA) of Case 1. A: 3D CTA shows an unruptured aneurysm (8 x 7 mm) of the right vertebral artery. B: DSA obtained just after the stent-assisted coil embolization of the aneurysm demonstrates a successful coil packing of the aneurysm and good patency of the right vertebral artery.
case_images: cureus-0017-00000077512-i01.jpg
case_images: PMC11828927_01_cureus-0017-00000077512-i01.jpg
case_images: FIG1
case_images: Magnetic resonance angiography (MRA) and three-dimensional (3D) computed tomography angiogram (3D CTA) revealed an unruptured aneurysm of the right vertebral artery (8 x 7mm) (Figure 1A). The procedure was completed uneventfully with successful occlusion of the aneurysm (Figure 1B).
case_images: Post-operative images of Case 1. A: Fluid-attenuated inversion recovery sequence (FLAIR) images of MRI obtained one hour after the procedure show a high-intensity lesion in the right lateral medulla oblongata. B: A follow-up FLAIR image of MRI obtained 17 days after the procedure shows no high-intensity lesion in the right lateral medulla oblongata.
case_images: cureus-0017-00000077512-i02.jpg
case_images: PMC11828927_01_cureus-0017-00000077512-i02.jpg
case_images: FIG2
case_images: T2-weighted images and fluid-attenuated inversion recovery sequence (FLAIR) images, however, revealed a high-intensity lesion in the right lateral medulla oblongata (Figure 2A). The symptoms improved within a week, and the lesion in the right lateral medulla oblongata disappeared on MRI 17 days after the procedure (Figure 2B).
case_images: PMC11828927_02
case_images: 3D computed tomography angiogram (CTA) and digital subtraction angiography (DSA) of Case2. A: 3D CTA of Case 2 shows severe stenosis of the basilar artery. B: DSA obtained just after stenting of the basilar artery demonstrates a complete dilatation of the basilar artery.
case_images: cureus-0017-00000077512-i03.jpg
case_images: PMC11828927_02_cureus-0017-00000077512-i03.jpg
case_images: FIG3
case_images: The patient had a normal renal function with 70.5 mL/min/1.73 m2 of eGFR. 3D CTA demonstrated a severe stenosis of the basilar artery distal to the antero-inferior cerebellar arteries (Figure 3A). Percutaneous transluminal angioplasty and stenting of the basilar artery were accomplished by introducing a 5-Fr guiding sheath into the left vertebral artery using a Wingspan stent (Stryker Neurovascular, Fremont, CA, USA) (Figure 3B).
case_images: Post-operative images of Case 2. A: Plain CT immediately after the procedure shows a high-density lesion in the left lateral medulla oblongata. B: Water-iodine image of dual-energy CT shows no lesions. C: T2 image of MRI obtained one day after the procedure shows no lesions.
case_images: cureus-0017-00000077512-i04.jpg
case_images: PMC11828927_02_cureus-0017-00000077512-i04.jpg
case_images: FIG4
case_images: Computed tomography (CT) revealed a high-density lesion in the left lateral medulla oblongata (Figure 4A). The lesion was thought to be a contrast leakage according to the water-iodine image of dual-energy CT (Figure 4B) and was diagnosed as CIE. Symptoms improved within a few days, and follow-up CT and MRI demonstrated the disappearance of the lesion (Figure 4C).