A rare sign of intracranial internal carotid artery dissection causing cerebral infarction: a case report and review of the literature.

We describe a patient with CT-proven ischemic infarction of the left middle cerebral artery (MCA) territory. The emergency CT, on admission, was suggestive of intracranial internal carotid artery dissection by demonstrating gaseous gap defects in the arterial wall and a subsequent thromboembolic process in the MCA. To our knowledge, there is no previous report regarding radiologically detected gas within the vessel wall or lumen secondary to dissection. We discuss this uncommon radiologic sign and its possible pathogenesis with a review of the literature.