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http://dx.doi.org/10.3340/jkns.2013.53.2.115

Spontaneous Anterior Cerebral Artery Dissection Presenting with Simultaneous Subarachnoid Hemorrhage and Cerebral Infarction in a Patient with Multiple Extracranial Arterial Dissections  

Park, Yung Ki (Department of Neurosurgery, Hanyang University Medical Center)
Yi, Hyeong-Joong (Department of Neurosurgery, Hanyang University Medical Center)
Lee, Young Jun (Department of Radiology, Hanyang University Medical Center)
Kim, Young-Seo (Department of Neurology, Hanyang University Medical Center)
Publication Information
Journal of Korean Neurosurgical Society / v.53, no.2, 2013 , pp. 115-117 More about this Journal
Abstract
Simultaneous subarachnoid hemorrhage and infarction is a quite rare presentation in a patient with a spontaneous dissecting aneurysm of the anterior cerebral artery. Identifying relevant radiographic features and serial angiographic surveillance as well as mode of clinical manifestation, either hemorrhage or infarction, could sufficiently determine appropriate treatment. Enlargement of ruptured aneurysm and progressing arterial stenosis around the aneurysm indicates impending risk of subsequent stroke. In this setting, prompt treatment with stent-assisted endovascular embolization can be a reliable alternative to direct surgery. When multiple arterial dissections are coexistent, management strategy often became complicated. However, satisfactory clinical results can be obtained by acknowledging responsible arterial site with careful radiographic inspection and antiplatelet medication.
Keywords
Dissecting aneurysm; Subarachnoid hemorrhage; Cerebral infarction; Anterior cerebral artery; Endovascular embolization;
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1 Amagasaki K, Yagishita T, Yagi S, Kuroda K, Nishigaya K, Nukui H : Serial angiography and endovascular treatment of dissecting aneurysms of the anterior cerebral and vertebral arteries. Case report. J Neurosurg 91 : 682-686, 1999   DOI
2 Huang YC, Chen YF, Wang YH, Tu YK, Jeng JS, Liu HM : Cervicocranial arterial dissection : experience of 73 patients in a single center. Surg Neurol 72 Suppl 2 : S20-S27; discussion S27, 2009   DOI
3 Inoue T, Fujimura M, Matsumoto Y, Kondo R, Inoue T, Shimizu H, et al. : Simultaneous occurrence of subarachnoid hemorrhage and cerebral infarction caused by anterior cerebral artery dissection treated by endovascular trapping. Neurol Med Chir (Tokyo) 50 : 574-577, 2010   DOI
4 Kitanaka C, Tanaka J, Kuwahara M, Teraoka A, Sasaki T, Takakura K, et al. : Nonsurgical treatment of unruptured intracranial vertebral artery dissection with serial follow-up angiography. J Neurosurg 80 : 667-674, 1994   DOI
5 Koyama S, Kotani A, Sasaki J : Spontaneous dissecting aneurysm of the anterior cerebral artery : report of two cases. Surg Neurol 46 : 55-61, 1996   DOI
6 Kurino M, Yoshioka S, Ushio Y : Spontaneous dissecting aneurysms of anterior and middle cerebral artery associated with brain infarction : a case report and review of the literature. Surg Neurol 57 : 428-436; discussion 436-438, 2002   DOI
7 Ohkuma H, Suzuki S, Kikkawa T, Shimamura N : Neuroradiologic and clinical features of arterial dissection of the anterior cerebral artery. AJNR Am J Neuroradiol 24 : 691-699, 2003
8 Redekop GJ : Extracranial carotid and vertebral artery dissection : a review. Can J Neurol Sci 35 : 146-152, 2008   DOI
9 Sato S, Toyoda K, Matsuoka H, Okatsu H, Kasuya J, Takada T, et al. : Isolated anterior cerebral artery territory infarction : dissection as an etiological mechanism. Cerebrovasc Dis 29 : 170-177, 2010   DOI
10 Suzuki K, Mishina M, Okubo S, Abe A, Suda S, Ueda M, et al. : Anterior cerebral artery dissection presenting subarachnoid hemorrhage and cerebral infarction. J Nippon Med Sch 79 : 153-158, 2012   DOI
11 Jensen MB, Chacon MR, Aleu A : Cervicocerebral arterial dissection. Neurologist 14 : 5-6, 2008   DOI
12 Yonas H, Agamanolis D, Takaoka Y, White RJ : Dissecting intracranial aneurysms. Surg Neurol 8 : 407-415, 1977