Journal of Korean Neurosurgical Society

The Korean Neurosurgical Society (대한신경외과학회)
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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)
  • Received : 2012.09.11
  • Accepted : 2013.02.04
  • Published : 2013.02.28
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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.

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References

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