2017 年 11 巻 5 号 p. 253-259
Objective: Idiopathic intracranial internal carotid artery dissection presenting with ischemia is a rare brain disease. We herein report two cases that we recently encountered.
Case Presentations: Case 1: A 16-year-old male. He had the onset with consciousness disturbance and left hemiparesis. Cerebral infarction of the right basal ganglia and dissection of the right internal carotid artery at the terminal portion (C1-2) were detected. The symptoms were transient and antithrombotic therapy was carried out. The symptoms were exacerbated after five days and stent placement was performed at the site of the dissection. The symptoms were alleviated after the procedure, and the condition improved to modified Rankin Scale (mRS) score of 0 three months after the onset.
Case 2: A 43-year-old female. She had the onset with weakness of the right upper extremity and dysarthria. Left cerebral infarction and dissection of the left internal carotid artery at C1-2 portion were detected. Since the symptoms were mild, antithrombotic therapy was carried out, and she was discharged with mRS 0.
Conclusion: Since the clinical course of this disease varies among patients, an appropriate therapeutic strategy must be selected according to the condition of each patient.