A Case of Middle Cerebral Artery Dissection Suspected Association with Blunt Head Trauma

Abstract

We describe a case of middle cerebral artery dissection after a mild blunt head trauma. A 63-year-old woman suddenly had right hemiparesis and dysarthria three hours after a blunt head trauma due to a traffic accident. Magnetic resonance (MR) imaging and MR angiography revealed acute infarction in left middle cerebral artery (MCA) region and left MCA occlusion was suspected. Digital subtraction angiography revealed severe stenosis and the presence of intimal flap on the M1 portion of left MCA. We diagnosed dissection of the MCA, and performed endovascular revascularization including stent placement. Eight months later, there was no restenosis and the patient recovered to modified Rankin Scale 2. It should be assumed that MCA dissection occurs several hours after a mild blunt head trauma.