title: Multiple vascular accidents including rupture of a sinus of valsalva aneurysm, a minor ischemic stroke and intracranial arterial anomaly in a patient with systemic congenital abnormalities: a case report.
abstract: A 39-year-old man with a history of rupture of a sinus of Valsalva aneurysm experienced an ischemic stroke. Although the patient presented left-sided hemiparesis for a week, no abnormal signals were indicated on diffusion-weighted imaging with repeated magnetic resonance scans. Carotid ultrasound and cerebral angiography were conducted, and they revealed hypoplasty of the left internal carotid artery with a low-lying carotid bifurcation at the level of the C6 vertebra. In addition, he was diagnosed with intellectual disabilities, evaluated by the Wechsler Adult Intelligence Scale-III, and congenital velopharyngeal insufficiency. We herein present the first report of a patient with cardio-cerebrovascular abnormalities, intellectual disabilities, and an otorhinolaryngological abnormality.
authors.affiliation: Division of Neurology, Department of Internal Medicine, Nippon Medical School, Tokyo, Japan.
authors.forename: Masataka
authors.initials: M
authors.lastname: Nakajima
authors.affiliation: Division of Neurology, Department of Internal Medicine, Nippon Medical School, Tokyo, Japan.
authors.forename: Arata
authors.initials: A
authors.lastname: Abe
authors.affiliation: Division of Neurology, Department of Internal Medicine, Nippon Medical School, Tokyo, Japan.
authors.forename: Yasuhiro
authors.initials: Y
authors.lastname: Nishiyama
authors.affiliation: Division of Neurology, Department of Internal Medicine, Nippon Medical School, Tokyo, Japan.
authors.forename: Mina
authors.initials: M
authors.lastname: Harada-Abe
authors.affiliation: Division of Neurology, Department of Internal Medicine, Nippon Medical School, Tokyo, Japan.
authors.forename: Akihito
authors.initials: A
authors.lastname: Kutsuna
authors.affiliation: Division of Neurology, Department of Internal Medicine, Nippon Medical School, Tokyo, Japan.
authors.forename: Yuya
authors.initials: Y
authors.lastname: Goto
authors.affiliation: Division of Neurology, Department of Internal Medicine, Nippon Medical School, Tokyo, Japan.
authors.forename: Seiji
authors.initials: S
authors.lastname: Okubo
authors.affiliation: Division of Neurology, Department of Internal Medicine, Nippon Medical School, Tokyo, Japan.
authors.forename: Masahiro
authors.initials: M
authors.lastname: Mishina
authors.affiliation: Division of Neurology, Department of Internal Medicine, Nippon Medical School, Tokyo, Japan.
authors.forename: Ken-Ichiro
authors.initials: K
authors.lastname: Katsura
authors.affiliation: Division of Neurology, Department of Internal Medicine, Nippon Medical School, Tokyo, Japan.
authors.forename: Yasuo
authors.initials: Y
authors.lastname: Katayama
keywords: Hypoplasty of internal carotid artery; Intellectual disability; Ischemic stroke; Low-lying carotid bifurcation; Rupture of the sinus of Valsalva