title: Simultaneous onset of anterior and middle cerebral artery dissections with an old vertebral artery dissection.
abstract: Multiple arterial dissections in the anterior circulation with simultaneous onset are extremely rare. We report a patient with infarctions caused by simultaneous arterial dissections in the right anterior cerebral artery and the left middle cerebral artery and discuss the characteristic feature of this vascular disorder. A 53-year-old woman presented with a severe headache and a mild aphasia. Magnetic resonance imaging revealed multiple acute cerebral infarctions in the left temporal and right frontal lobes. The initial angiographic findings revealed arterial dissections of the anterior cerebral, left middle cerebral, and right vertebral arteries. The follow-up angiographic examination found improvement of the stenosis in both the anterior cerebral and middle cerebral arteries. We have concluded that the lesion of the vertebral artery was not in an acute stage, because no interval change was seen during the radiologic evaluation. She underwent conservative therapy, and her symptoms disappeared. Multiple arterial dissections are rare, especially those developing simultaneously in different arteries. This is the first case of multiple arterial dissections of the different arteries in the anterior circulation manifesting cerebral infarction simultaneously.
authors.affiliation: Department of Neurosurgery, University of Yamanashi, Yamanashi, Japan. Electronic address: tkmiku0619@yahoo.co.jp.
authors.forename: Tatsuya
authors.initials: T
authors.lastname: Kato
authors.forename: Takashi
authors.initials: T
authors.lastname: Yagi
authors.forename: Hideyuki
authors.initials: H
authors.lastname: Yoshioka
authors.forename: Masakazu
authors.initials: M
authors.lastname: Ogiwara
authors.forename: Toru
authors.initials: T
authors.lastname: Horikoshi
authors.forename: Hiroyuki
authors.initials: H
authors.lastname: Kinouchi
mesh_terms: D000784:Aortic Dissection / Q000188:drug therapy / Q000473:pathology*; D020771:Anterior Cerebral Artery / Q000473:pathology*; D000959:Antihypertensive Agents / Q000627:therapeutic use; D003251:Constriction, Pathologic; D038524:Diffusion Magnetic Resonance Imaging; D005260:Female; D006801:Humans; D020244:Infarction, Middle Cerebral Artery / Q000150:complications / Q000473:pathology; D008875:Middle Aged; D020768:Middle Cerebral Artery / Q000473:pathology*; D020217:Vertebral Artery Dissection / Q000150:complications*
chemical_list: D000959:Antihypertensive Agents