Yoshio Araki1, Yasushi Takagi2, Yohei Mineharu2, Hatasu Kobayashi3, Susumu Miyamoto2, Toshihiko Wakabayashi4. 1. Department of Neurosurgery, Nagoya University Graduate School of Medicine, 65 Tsurumai-cho, Showa-ku, Nagoya, Aichi, 466-8550, Japan. y.araki@med.nagoya-u.ac.jp. 2. Department of Neurosurgery, Kyoto University Graduate School of Medicine, Kyoto, Japan. 3. Department of Health and Environmental Sciences, Kyoto University Graduate School of Medicine, Kyoto, Japan. 4. Department of Neurosurgery, Nagoya University Graduate School of Medicine, 65 Tsurumai-cho, Showa-ku, Nagoya, Aichi, 466-8550, Japan.
Abstract
BACKGROUND: Focal cerebral arteriopathy includes unifocal or multifocal lesions that are unilateral or bilateral. Large- and/or medium-sized vessels are involved and can be visualized on angiography. CASE REPORT: We report a case of cerebral infarction in a 9-year-old Japanese female who presented with a transient ischemic attack. Steno-occlusion involving the distal part of the internal carotid artery, proximal middle cerebral artery, and anterior cerebral artery was observed. Digital subtraction angiography demonstrated a beaded appearance in the cervical portion of the diseased internal carotid artery. Revascularization surgery was performed 45 days after the onset. A new infarction appeared on the other side of the anterior cerebral artery territory 7 months after the first onset. Antiplatelets and vasodilators were administered, and no progression was observed during 18 months of follow-up. Genetic analysis did not show ring finger protein 213 (RNF213)-related moyamoya disease, and pathological examination revealed no characteristics of fibromuscular dysplasia. CONCLUSION: The radiological and genetic features coincided with focal cerebral arteriopathy, which is a distinct entity from fibromuscular dysplasia and RNF213-related moyamoya disease.
BACKGROUND:Focal cerebral arteriopathy includes unifocal or multifocal lesions that are unilateral or bilateral. Large- and/or medium-sized vessels are involved and can be visualized on angiography. CASE REPORT: We report a case of cerebral infarction in a 9-year-old Japanese female who presented with a transient ischemic attack. Steno-occlusion involving the distal part of the internal carotid artery, proximal middle cerebral artery, and anterior cerebral artery was observed. Digital subtraction angiography demonstrated a beaded appearance in the cervical portion of the diseased internal carotid artery. Revascularization surgery was performed 45 days after the onset. A new infarction appeared on the other side of the anterior cerebral artery territory 7 months after the first onset. Antiplatelets and vasodilators were administered, and no progression was observed during 18 months of follow-up. Genetic analysis did not show ring finger protein 213 (RNF213)-related moyamoya disease, and pathological examination revealed no characteristics of fibromuscular dysplasia. CONCLUSION: The radiological and genetic features coincided with focal cerebral arteriopathy, which is a distinct entity from fibromuscular dysplasia and RNF213-related moyamoya disease.
Authors: Timothy J Bernard; Marilyn J Manco-Johnson; Warren Lo; Mark T MacKay; Vijeya Ganesan; Gabrielle DeVeber; Neil A Goldenberg; Jennifer Armstrong-Wells; Michael M Dowling; E Steve Roach; Mark Tripputi; Heather J Fullerton; Karen L Furie; Susanne M Benseler; Lori C Jordan; Adam Kirton; Rebecca Ichord Journal: Stroke Date: 2011-12-08 Impact factor: 7.914
Authors: R H Swartz; S S Bhuta; R I Farb; R Agid; R A Willinsky; K G Terbrugge; J Butany; B A Wasserman; D M Johnstone; F L Silver; D J Mikulis Journal: Neurology Date: 2009-02-17 Impact factor: 9.910
Authors: K P J Braun; M M M Bulder; S Chabrier; F J Kirkham; C S P Uiterwaal; M Tardieu; G Sébire Journal: Brain Date: 2008-11-27 Impact factor: 13.501