title: A case of intracranial arterial dolichoectasia with 4 repeated cerebral infarctions in 6 months and enlargement of basilar artery.
abstract: A 78-year-old man was admitted to our hospital because of sudden right hemiparesis and dysarthria. His cranial MRI showed an area of hyperintensity in left pons on DWI and MRA revealed dilated, elongated and tortuous intracranial artery. We diagnosed as acute phase ischemic stroke and intracranial arterial dolichoectasia (IADE). Intravenous infusion of rt-PA was performed 157 minutes after the onset of symptoms, and his hemiparesis improved. However, he subsequently suffered from cerebral infarction 4 times in 6 months, and we treated him twice with thrombolytic therapy. Although thrombolytic therapy was effective in the short term and antithrombotic therapy was continued, he had bilateral hemiplegia and severe dysphagia because of repeated cerebral infarctions. Hence basilar artery was dilated with intramural hemorrhage over 6 months, and we discontinued antithrombolytic therapy. It is possible that antithrombolytic therapy affects enlargement of IADE. Antithrombolytic therapy for IADE should be done carefully.
authors.affiliation: Department of Neurology, Stroke Center, TOYOTA Memorial Hospital.
authors.forename: Hideyuki
authors.initials: H
authors.lastname: Moriyoshi
authors.forename: Soma
authors.initials: S
authors.lastname: Furukawa
authors.forename: Mai
authors.initials: M
authors.lastname: Iwata
authors.forename: Junichiro
authors.initials: J
authors.lastname: Suzuki
authors.forename: Noriyoshi
authors.initials: N
authors.lastname: Nakai
authors.forename: Suguru
authors.initials: S
authors.lastname: Nishida
authors.forename: Yasuhiro
authors.initials: Y
authors.lastname: Ito
mesh_terms: D000208:Acute Disease; D001488:Basilar Artery / Q000000981:diagnostic imaging / Q000473:pathology*; D002544:Cerebral Infarction / Q000000981:diagnostic imaging / Q000209:etiology*; D038524:Diffusion Magnetic Resonance Imaging; D004108:Dilatation, Pathologic / Q000000981:diagnostic imaging; D005260:Female; D006801:Humans; D020765:Intracranial Arterial Diseases / Q000150:complications* / Q000000981:diagnostic imaging* / Q000188:drug therapy; D018810:Magnetic Resonance Angiography; D008875:Middle Aged; D011994:Recombinant Proteins / Q000008:administration & dosage / Q000009:adverse effects; D012008:Recurrence; D020521:Stroke / Q000150:complications / Q000000981:diagnostic imaging / Q000188:drug therapy; D015912:Thrombolytic Therapy; D013997:Time Factors; D010959:Tissue Plasminogen Activator / Q000008:administration & dosage / Q000009:adverse effects; D014715:Vertebrobasilar Insufficiency / Q000150:complications* / Q000000981:diagnostic imaging* / Q000188:drug therapy
chemical_list: D011994:Recombinant Proteins; D010959:Tissue Plasminogen Activator