Abstract
A 47-year-old man was admitted to our hospital due to dysarthria and right hemiparesis without headache. A brain CT scan and MRI revealed cerebral infarction in the left frontal lobe. Cervical echo and cervical MRA did not demonstrate arteriosclerosis of the carotid arteries and intracranial cerebral arteries. A holter electrocardiogram and echocardiography yielded normal findings. Collagen diseases, anti-phospholipid antibody syndrome, sarcoidosis, protein C deficiency and protein S deficiency were not detected. We were unable to diagnose the cause of the cerebral infarction, but suspected a dissecting aneurysm. We therefore performed cerebral angiography, and a dissecting aneurysm with pearl and string signs at the A2 segment of the anterior cerebral artery was found. In the classification of the causes of cerebral infarction in patients with juvenile-onset, atherothrombotic infarction, cerebral embolism and "other causes of cerebral infarction" are recognized. Cerebral angiography was useful for making the diagnosis with anterior cerebral artery dissection in our case. It is important that we actively diagnose cerebral artery dissection as a cause of juvenile-onset stroke.
