BACKGROUND: Intracranial arterial dissection usually leads to cerebral infarction or subarachnoid hemorrhage (SAH). It is rare to see both complications in one clinical scenario. METHODS: Case report and review of the literature. RESULTS: A 48-year-old woman suffered a left middle cerebral infarct from a dissection of the left supraclinoid ICA. As she was recovering from the ischemic stroke 5 days later she suffered a SAH. The SAH was caused by rupture of a dissecting pseudoaneurysm, which only became evident on repeat catheter angiography. The dissecting pseudoaneurysm was treated with coil occlusion. CONCLUSION: Intracranial ICA dissections are typically associated with either ischemic or hemorrhagic presentation. We report an unusual case of a patient who suffered a SAH a few days after an ischemic stroke from the dissection. This case contradicts the long-held dogma that intracranial dissection can have either an ischemic or a hemorrhagic presentation, but not both.
BACKGROUND: Intracranial arterial dissection usually leads to cerebral infarction or subarachnoid hemorrhage (SAH). It is rare to see both complications in one clinical scenario. METHODS: Case report and review of the literature. RESULTS: A 48-year-old woman suffered a left middle cerebral infarct from a dissection of the left supraclinoid ICA. As she was recovering from the ischemic stroke 5 days later she suffered a SAH. The SAH was caused by rupture of a dissecting pseudoaneurysm, which only became evident on repeat catheter angiography. The dissecting pseudoaneurysm was treated with coil occlusion. CONCLUSION: Intracranial ICA dissections are typically associated with either ischemic or hemorrhagic presentation. We report an unusual case of a patient who suffered a SAH a few days after an ischemic stroke from the dissection. This case contradicts the long-held dogma that intracranial dissection can have either an ischemic or a hemorrhagic presentation, but not both.
Authors: D Georgiadis; O Lanczik; S Schwab; S Engelter; R Sztajzel; M Arnold; M Siebler; S Schwarz; P Lyrer; R W Baumgartner Journal: Neurology Date: 2005-05-10 Impact factor: 9.910
Authors: Sanne M Zinkstok; Mervyn D I Vergouwen; Stefan T Engelter; Philippe A Lyrer; Leo H Bonati; Marcel Arnold; Heinrich P Mattle; Urs Fischer; Hakan Sarikaya; Ralf W Baumgartner; Dimitrios Georgiadis; Céline Odier; Patrik Michel; Jukka Putaala; Martin Griebe; Nils Wahlgren; Niaz Ahmed; Nan van Geloven; Rob J de Haan; Paul J Nederkoorn Journal: Stroke Date: 2011-07-28 Impact factor: 7.914
Authors: Claudia Chaves; Conrado Estol; Maria M Esnaola; Kenneth Gorson; Margaret O'Donoghue; L Dana De Witt; Louis R Caplan Journal: Arch Neurol Date: 2002-06