Acute bilateral anterior circulation stroke due to anomalous cerebral vasculature: a case report.
BACKGROUND
Simultaneous bilateral cerebrovascular infarction is relatively rare and its initial presentation as a space-occupying lesion is extremely uncommon. However, bilateral infarction can result from unilateral occlusion of anomalous cerebral vasculature.


METHODS
We report the case of a man presenting with lower limb weakness and aphasia of acute onset with initial computerised tomography suggesting bifrontal neoplasm. However, further investigation confirmed bilateral anterior cerebral artery territory infarction with a hypoplastic left anterior cerebral artery with the right anterior cerebral artery supplying both frontal lobes (an anatomical variant). We present the clinical and diagnostic features of this presentation and attempt to ascertain, by reviewing existent medical literature, the frequency and patterns of structural variations in cerebral vasculature.


CONCLUSIONS
Simultaneous bilateral cerebral infarction can be the result of a unilateral cerebral artery occlusion and this can potentially mimic a space-occupying lesion. Anomalies of cerebral vasculature are not as rare as is usually believed and this should be borne in mind when investigating unusual presentations of cerebrovascular infarction.
The Walton Centre for Neurology and Neurosurgery, Liverpool, UK. franmenezes77@yahoo.co.uk
Brian F
BF
Menezes
Beverley
B
Cheserem
Jothy
J
Kandasamy
Donnacha
D
O'Brien