Isolated middle cerebral artery dissection with atherosclerosis: A case report

Sang Hun Lee, Sun Ju Lee, Il Eok Jung, Jin-Man Jung

Research output: Contribution to journalArticle

Abstract

Isolated middle cerebral artery (MCA) dissection with atherosclerosis is a rare entity, and its clinical progression is not well known. We recently came across a case of isolated MCA dissection with atherosclerosis. A 62-year-old man presented to the emergency department with right-sided weakness and mild aphasia. Diffusion-weighted imaging (DWI) showed a multifocal infarction in the left MCA region, and perfusion Magnetic resonance imaging (MRI) detected a moderate time delay in the left MCA region. High-resolution MRI and transfemoral cerebral angiography revealed that the atherosclerotic plaque was accompanied by the dissecting intimal flap. Despite 40 days of antiplatelet therapy, the ischemic stroke recurred and the dissection did not heal. After stenting, the MCA and intracranial circulation revealed a widened lumen and improved flow across the dissection, and no embolic sequelae in the distal intracranial circulation. This case suggest that in MCA dissection with atherosclerosis, early stage intracranial stenting may be a better therapeutic strategy than medical treatment, to prevent recurrent cerebral infarction.

Original languageEnglish
Pages (from-to)259-262
Number of pages4
JournalNeurology Asia
Volume23
Issue number3
Publication statusPublished - 2018 Sep 1

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Keywords

  • Atherosclerosis
  • Middle cerebral artery dissection
  • Middle cerebral artery dissection with atherosclerosis

ASJC Scopus subject areas

  • Neurology
  • Clinical Neurology

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