可逆性脳血管攣縮症候群を合併し，くも膜下出血と脳梗塞を同時発症した左前大脳動脈解離の 1例

碓井 遼; 阿久津 二夫; 井島 大輔; 北村 英二; 金子 淳太郎; 中村 幹昭; 栁田 敦子; 金子 厚; 近藤 裕子; 須賀 裕樹; 髙橋 和沙; 永井 俊行; 山本 大輔; 西山 和利

doi:10.3995/jstroke.10625

This article has now been updated. Please use the final version.

A case of left anterior cerebral artery dissection causing both infarction and subarachnoid hemorrhage accompanied with reversible cerebral vasoconstriction syndrome

Ryo Usui, Tsugio Akutsu, Daisuke Ishima, Eiji Kitamura, Juntaro Kaneko, Masaaki Nakamura, Atsuko Yanagida, Atsushi Kaneko, Yuko Kondo, Hiroki Suga, Kazusa Takahashi, Toshiyuki Nagai, Daisuke Yamamoto, Kazutoshi Nishiyama

Author information

Ryo Usui
Department of Neurology, Kitasato University School of Medicine
Tsugio Akutsu
Department of Neurology, Kitasato University School of Medicine
Daisuke Ishima
Department of Neurology, Kitasato University School of Medicine
Eiji Kitamura
Department of Neurology, Kitasato University School of Medicine
Juntaro Kaneko
Department of Neurology, Kitasato University School of Medicine
Masaaki Nakamura
Department of Neurology, Kitasato University School of Medicine
Atsuko Yanagida
Department of Neurology, Kitasato University School of Medicine
Atsushi Kaneko
Department of Neurology, Kitasato University School of Medicine
Yuko Kondo
Department of Neurology, Kitasato University School of Medicine
Hiroki Suga
Department of Neurology, Kitasato University School of Medicine
Kazusa Takahashi
Department of Neurology, Kitasato University School of Medicine
Toshiyuki Nagai
Department of Neurology, Kitasato University School of Medicine
Daisuke Yamamoto
Department of Neurosurgery, Kitasato University School of Medicine
Kazutoshi Nishiyama
Department of Neurology, Kitasato University School of Medicine

Keywords: cerebral artery dissection, reversible cerebral vasoconstriction syndrome, stroke, cortical subarachnoid hemorrhage

JOURNAL FREE ACCESS Advance online publication

Article ID: 10625

DOI https://doi.org/10.3995/jstroke.10625

The final version of this article is now available: Vol. 41 (2019), No. 2 pp. 120-123

Details

Abstract

A 48-year-old woman was admitted to our hospital due to sudden motor aphasia and right hemiplegia with lower limb dominance. Computed tomography angiography (CTA) revealed occlusion of the left anterior cerebral artery (ACA) and multiple stenosis of the bilateral major arteries. MRI showed a new infarct lesion inside the left frontal lobe and subarachnoid hemorrhage around the sulcus. Digital subtraction angiography demonstrated pearl and string sign beyond the left A2 segment. Follow-up CTA showed the improvement of the multiple stenosis. We therefore, diagnosed left ACA dissection accompanied with reversible cerebral vasoconstriction syndrome. This case is valuable because similar cases have not ever been reported.

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