Clinical characteristics and neuroradiologic findings in 18 cases of anterior cerebral artery dissection
Case No. | Age (yr)/Sex | Presentation at Onset | Site of Lesion | Initial Angiographic Findings | Confirmation of Dissection | Outcome |
---|---|---|---|---|---|---|
1 | 39/F | Bleeding | A1 | S + D | Ope | VS |
2 | 66/F | Bleeding | A1 | S + D | Ope | VS |
3 | 66/F | Bleeding | A1 | S + D | Ope | MD |
4 | 49/F | Bleeding | A2 | S | DL† | GR |
5 | 53/M | Bleeding | A3 | S | DL | GR |
6 | 43/F | Ischemia | A1–2 | S | IMH | GR |
7 | 50/F | Ischemia | A2 | S | DL† | GR |
8 | 65/M | Ischemia | A2 | S | DL | GR |
9 | 56/M | Ischemia | A2 | S + D | DL† | GR |
10 | 67/F | Ischemia | A1–2 | S + D | DL† | GR |
11 | 52/F | Ischemia | A2 | S + D | IMH | GR |
12 | 36/M | Ischemia | A2 | S | IMH | MD |
13 | 56/F | Ischemia | A2 | S + D | DL | GR |
14 | 50/F | Ischemia | A2 | S | IMH, DL | GR |
15 | 40/M | Combined* | A2 | S | IMH, DL | GR |
16 | 64/F | Combined* | A2 | S + D | IMH, DL | GR |
17 | 49/F | Combined* | A2 | S + D | Ope | GR |
18 | 49/M | Combined* | A2–3 | S | DL | GR |
Note.—F indicates female; M, male; S + D, stenosis with dilation; S, stenosis without dilation; Ope, discoloration of affected artery around aneurysmal dilation due to intramural hematoma seen during operation; DL, double lumen sign seen on cerebral angiograms; IMH, hyperintensity around signal void due to intramural hematoma seen on T1-weighted MR images; VS, vegetative state; MD, moderate disability; GR, good recovery.
* Four cases showed ischemic symptoms and CT evidence of slight subarachnoid hemorrhage on initial CT scans.
† In 4 cases, the double lumen sign was seen on follow-up angiography.