Neurological Surgery No Shinkei Geka Volume 38, Issue 3 (March 2010)

Nontraumatic Arterial Dissection of the Anterior Cerebral Artery with Simultaneous Cerebral Infarction and Subarachnoid Hemorrhage: A Case Report Shigeyoshi KIMURA 1,2 , Takahiro IGARASHI 2 , Akio KOTANI 1 , Yoichi KATAYAMA 2 1Department of Neurological Surgery,Kasukabe Municipal Hospital 2Division of Neurosurgery,Department of Neurological Surgery,Nihon University School of Medicine Keyword: nontraumatic arterial dissection , anterior cerebral artery , cerebral infarction , subarachnoid hemorrhage , conservative treatment pp.273-278
Published Date 2010/3/10
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 We encountered a case of nontraumatic arterial dissection of the anterior cerebral artery (ACA) which exhibited cerebral infarction and subarachnoid hemorrhage (SAH) simultaneously, and whose symptoms were improved by conservative treatment. A 55-year-old female presenting with headache and weakness in her left leg was admitted to our hospital. CT scans on admission revealed SAH in the interhemispheric fissure and surface of the right frontal lobe, but CT scans at 3 days after onset demonstrated cerebral infarction in the medial part of the right frontal lobe. Cerebral angiography on day 6 disclosed an aneurysmal dilatation and narrowing at the right A2-A3 segment. We continued conservative therapy including blood pressure control, since there was no symptomatic deterioration. The aneurysmal dilatation disappeared and the weakness of the left leg also improved. This case indicates that conservative treatment could be an option for the management of nontraumatic arterial dissection of the ACA with simultaneous cerebral infarction and SAH.

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Neurological Surgery 脳神経外科
38巻3号 (2010年3月)
電子版ISSN 1882-1251 印刷版ISSN 0301-2603 医学書院