Journal of Cerebrovascular and Endovascular Neurosurgery

Korean Society of Cerebravascular Surgeons (대한뇌혈관외과학회)
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Various treatment modalities for isolated intracranial middle cerebral arterial dissection with progressive ischemic symptoms: 2 case reports of endovascular stent and bypass surgery

  • Chanbo Eun (Department of Neurological Surgery, Asan Medical Center, University of Ulsan College of Medicine) ;
  • Hongbum Kim (Department of Neurological Surgery, Gangneung Asan Hospital, University of Ulsan College of Medicine) ;
  • Suhee Cho (Department of Neurological Surgery, Gangneung Asan Hospital, University of Ulsan College of Medicine) ;
  • Kuhyun Yang (Department of Neurological Surgery, Gangneung Asan Hospital, University of Ulsan College of Medicine)
  • Received : 2023.07.25
  • Accepted : 2023.09.24
  • Published : 2024.06.30
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Abstract

Isolated middle cerebral artery dissection (MCAD) is rare but increasingly recognized as a significant clinical entity, particularly in younger adults. Ischemic stroke is the most common manifestation in symptomatic cases but symptoms can vary in severity from headaches to severe neurologic deficits. Due to its rarity and unpredictable clinical course, there is no established treatment strategy for isolated MCAD. Through two case reports, we reviewed the post-operative clinical course of MCAD under different treatment modalities. Case 1 was a 21-year-old woman who presented to the emergency department with headaches and left-side hemiparesis. Isolated MCAD was diagnosed and she was successfully treated with the placement of a self-expandable stent and subsequent chemical angioplasty for post-stent vasospasm. Case 2 was a 35-year-old woman who presented to the emergency department with left-side hemiparesis and dysarthria. Isolated MCAD was diagnosed and she was successfully treated with superficial temporal artery (STA) to middle cerebral artery (MCA) anastomosis.

Keywords

Acknowledgement

We are indebted to the neuroradiologists in our institute, who are always cooperative with us in the treatment of complex neurosurgical diseases.

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