title: Post-ischaemic hyperperfusion in traumatic middle cerebral artery dissection detected by arterial spin labelling of magnetic resonance imaging.
abstract: We report a patient with a traumatic middle cerebral artery dissection, which showed hyperperfusion in the territory supplied by the left middle cerebral artery. A 45-year-old man experienced speech disturbance and motor weakness in his right hemibody on the day following mild head trauma. His symptoms worsened on the fourth day. Magnetic resonance imaging showed narrowing in the left M1 portion of the middle cerebral artery. Angiography showed narrowing and dilatation in the left middle cerebral artery trunk. The lesion was diagnosed as a dissection of the middle cerebral artery. Arterial spin labelling of magnetic resonance imaging and single photon emission computed tomography showed increased cerebral blood flow in the left temporal region compared with the right. The patient was treated conservatively and the symptoms gradually improved. The hyperperfusion observed on arterial spin labelling and single photon emission computed tomography gradually improved and disappeared on the 25th day. This is the first reported case of traumatic middle cerebral artery dissection, which showed post-ischaemic hyperperfusion in the territory of the affected artery. To detect hyperperfusion in the brain, arterial spin labelling is a useful technique.
authors.affiliation: Department of Neurosurgery, Kanto Rosai Hospital, Japan Department of Neurosurgery, Yokohama Sakae Kyosai Hospital, Japan nomura413jp@yahoo.co.jp.
authors.forename: Motohiro
authors.initials: M
authors.lastname: Nomura
authors.affiliation: Department of Neurosurgery, Yokohama Sakae Kyosai Hospital, Japan.
authors.forename: Akira
authors.initials: A
authors.lastname: Tamase
authors.affiliation: Department of Neurosurgery, Yokohama Sakae Kyosai Hospital, Japan.
authors.forename: Tomoya
authors.initials: T
authors.lastname: Kamide
authors.affiliation: Department of Neurosurgery, Yokohama Sakae Kyosai Hospital, Japan.
authors.forename: Kentaro
authors.initials: K
authors.lastname: Mori
authors.affiliation: Department of Neurosurgery, Yokohama Sakae Kyosai Hospital, Japan.
authors.forename: Syunsuke
authors.initials: S
authors.lastname: Seki
authors.affiliation: Department of Neurosurgery, Yokohama Sakae Kyosai Hospital, Japan.
authors.forename: Yu
authors.initials: Y
authors.lastname: Iida
authors.affiliation: Department of Radiology, Yokohama Sakae Kyosai Hospital, Japan.
authors.forename: Kei-Ichiro
authors.initials: K
authors.lastname: Suzuki
authors.affiliation: Department of Radiology, Yokohama Sakae Kyosai Hospital, Japan.
authors.forename: Takae
authors.initials: T
authors.lastname: Aoki
authors.affiliation: Department of Radiology, Yokohama Sakae Kyosai Hospital, Japan.
authors.forename: Ken-Ichi
authors.initials: K
authors.lastname: Hirano
authors.affiliation: Department of Radiology, Yokohama Sakae Kyosai Hospital, Japan.
authors.forename: Mitsuyuki
authors.initials: M
authors.lastname: Takahashi
authors.affiliation: Department of Neurology, Yokohama Sakae Kyosai Hospital, Japan.
authors.forename: Yuichi
authors.initials: Y
authors.lastname: Kawabata
authors.affiliation: Department of Neurology, Yokohama Sakae Kyosai Hospital, Japan.
authors.forename: Tatsu
authors.initials: T
authors.lastname: Nakano
authors.affiliation: Department of Neurosurgery, Taguchi Neurosurgical Clinic, Japan.
authors.forename: Hiroki
authors.initials: H
authors.lastname: Taguchi
mesh_terms: D020215:Carotid Artery, Internal, Dissection / Q000000981:diagnostic imaging* / Q000209:etiology*; D002548:Cerebral Revascularization / Q000009:adverse effects*; D006801:Humans; D021621:Imaging, Three-Dimensional; D007511:Ischemia / Q000601:surgery*; D018810:Magnetic Resonance Angiography; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D013113:Spin Labels; D015899:Tomography, Emission-Computed, Single-Photon
chemical_list: D013113:Spin Labels
keywords: Post-ischaemic hyperperfusion; arterial spin labelling; dissection; head trauma; middle cerebral artery; single photon emission computed tomography