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Neurology India, Vol. 56, No. 1, January-March, 2008, pp. 102 Neuroimage MRI and MRA in spontaneous intracranial arterial dissection Raghavendra S, Thomas SanjeevV, Thamburaj Krishnamoorthy, Thomas Bejoy Department of Neurology, Sree Chitra Tirunal Institute for Medical Sciences and Technology, Trivandrum Date of Acceptance: 12-Feb-2007 Code Number: ni08032 A 19-year-old man, previously asymptomatic, presented with acute onset headache followed by right hemiplegia and global aphasia. A diffusion weighted MRI showed acute infarct of the left middle cerebral artery (MCA) territory [Figure - 1]A. Three-dimensional Multiple Overlapping Thin Slab Acquisition (MOTSA) MR Angiography [Figure - 1]B and source images showed dissection of M1 segment of the left MCA. [1] The dissection was predicted on conventional imaging as a double lumen was visible on T2 weighted and proton density cross-sectional images of the M1 segment [Figure - 1]C. Digital subtraction angiography (DSA) showed only occluded left Middle Cerebral Artery (MCA) with irregular dilatation of left supraclinoid portion of Internal Carotid Artery (ICA) [Figure - 1]D. Arterial dissection is being increasingly recognized as a cause of stroke in the young. However, its occurrence in the absence of systemic diseases or antecedent trauma is extremely uncommon in the intracranial circulation. [2] Appropriate proton density image may occasionally be the only sequence demonstrating the changes on conventional imaging and should be carefully looked for. Invasive procedures like DSA may not be of added use and should be judiciously used. References
Copyright 2008 - Neurology India The following images related to this document are available:Photo images[ni08032f1.jpg] |
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