A case of arterial dissection of bilateral anterior cerebral arteries

Abstract

A 52-year-old man presented with a non-traumatic arterial dissection of bilateral anterior cerebral arteries (ACAs) manifesting as headache and left-sided hemiparesis, followed by consciousness disturbance and paraparesis of lower extremities. Magnetic resonance imaging (MRI) revealed cerebral infarction in his bilateral frontal lobes. MRI angiography (MRA), CT angiography (CTA) and digital subtraction angiography (DSA) revealed arterial dissection of bilateral A2 and A3 portions that progressed in two days. He has recovered well with conservative treatment and rehabilitation for several months. We discuss the mechanism by which the arterial dissection occurred simultaneously in the bilateral A2 portions.