ALTERED VERTEBROBASILAR FLOW IN CHILDREN - ANGIOGRAPHIC, MR, AND MR ANGIOGRAPHIC FINDINGS

PURPOSE: To characterize the clinical, MR, MR angiographic, and conven tional angiographic findings in vertebrobasilar disease in children. M ETHODS: Eight children with posterior circulation ischemia and infarct ion had conventional spin-echo MR and MR angiography of the head and n eck. Six patients had conventional angiography. RESULTS: Six patients had alteration of vertebral or basilar artery flow void on spin-echo i mages. MR angiography showed all six cases of angiographically proved vertebrobasilar dissection or occlusion despite overestimating the ext ent of arterial abnormality in two patients. In two patients the intra cranial peripheral branch cutoff shown at angiography was correctly pr edicted on screening MR angiography. CONCLUSION: Posterior circulation infarction in children is usually secondary to traumatic injury to th e vertebrobasilar circulation. MR and MR angiography noninvasively sho w vertebrobasilar flow disturbances and compare favorably with angiogr aphy in documenting dissection or occlusion of the vertebrobasilar cir culation. MR angiography may obviate the need for invasive angiography in these children at diagnosis and during follow-up of anticoagulatio n therapy.