We report the case of a 45-year-old female who presented with acute left abdominal pain and subsequently developed a left partial Brown-Séquard syndrome. Spinal fluid, inflammatory and prothrombotic tests were unremarkable. Magnetic resonance showed a left intraforaminal disc prolapse at the T9–T10 level and a hyperintense lesion on T2-weighted images in the left postero-lateral cord at the T8–T9 level with restricted diffusion on DWI imaging. A diagnosis of spinal cord infarction due to compromise of the left T8 thoracic radicular artery was made. The patient was managed conservatively and at the 3 months follow-up, she was ambulant and able to walk small distances without a walker.
We report the case of a 70-year-old woman who presented with an acute ischemic stroke involving the left frontal operculum secondary to an M2 dissection and a concomitant completely thrombosed aneurysm of the left distal middle cerebral artery. Initial imaging work-up was inconclusive due to the lack of typical radiographic features and only repeated imaging studies pointed towards the presence of an arterial dissection combined with a completely thrombosed aneurysm. The aneurysm was partially clipped and wrapped with excellent clinical result at 1-year follow-up. The clinical, imaging and therapeutic challenges of this rare entity are discussed.
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