Dilated Outer Diameter of the Dissected Artery: Acute Bilateral Anterior Cerebral Artery Dissection Evaluated by Repeat Magnetic Resonance Cisternography —Case Report—

Morio NAGAHATA; Hiroko SEINO; Shinya KAKEHATA; Kohei MORIMOTO; Takahiro NAKANO; Kenichiro ASANO; Norihito SHIMAMURA; Hiroki OHKUMA

doi:10.2176/nmc.50.1095

Case Reports

Dilated Outer Diameter of the Dissected Artery: Acute Bilateral Anterior Cerebral Artery Dissection Evaluated by Repeat Magnetic Resonance Cisternography

—Case Report—

Morio NAGAHATA, Hiroko SEINO, Shinya KAKEHATA, Kohei MORIMOTO, Takahiro NAKANO, Kenichiro ASANO, Norihito SHIMAMURA, Hiroki OHKUMA

Author information

Morio NAGAHATA
Department of Radiology and Radiation Oncology, Hirosaki University Graduate School of Medicine
Hiroko SEINO
Department of Radiology and Radiation Oncology, Hirosaki University Graduate School of Medicine
Shinya KAKEHATA
Department of Radiology and Radiation Oncology, Hirosaki University Graduate School of Medicine
Kohei MORIMOTO
Department of Radiology and Radiation Oncology, Hirosaki University Graduate School of Medicine
Takahiro NAKANO
Department of Neurosurgery, Hirosaki University Graduate School of Medicine
Kenichiro ASANO
Department of Neurosurgery, Hirosaki University Graduate School of Medicine
Norihito SHIMAMURA
Department of Neurosurgery, Hirosaki University Graduate School of Medicine
Hiroki OHKUMA
Department of Neurosurgery, Hirosaki University Graduate School of Medicine

Keywords: anterior cerebral artery, dissection, magnetic resonance imaging, angiography, magnetic resonance cisternography

JOURNAL OPEN ACCESS

2010 Volume 50 Issue 12 Pages 1095-1098

DOI https://doi.org/10.2176/nmc.50.1095

Details

Abstract

A 42-year-old male patient presented with an anterior cerebral artery (ACA) dissection manifesting as sudden onset of severe headache. Initial computed tomography revealed faint subarachnoid hemorrhage in the frontal region. Initial angiography showed tapering stenosis at the A₂ segment of right ACA. The patient was admitted to our hospital and treated conservatively. Magnetic resonance (MR) imaging and angiography did not detect intramural hematoma, intimal flap, or double lumen at the stenotic right A₂ segment. The ACA dissection was difficult to confirm based on the findings on day 0. ACA dissection was confirmed by improvement of the right ACA stenosis on follow-up angiography on day 14. On the other hand, MR cisternography revealed a fusiform dilatation of the vascular outer contour at the right A₂ on day 0, which had resolved on day 14. Cerebral angiography and MR cisternography similarly suggested asymptomatic contralateral (left) A₂ dissection on day 14. Fusiform dilatation of the vascular outer contour at the affected segment on MR cisternography may be indicative of arterial dissection in the acute phase.

Corresponding author

Register with J-STAGE for free!