Background Bilateral infarction in the anterior cerebral artery vascular territory is rare and usually results from rupture of an aneurysm of the anterior communicating artery. In the case of an anomaly of the anterior part of the circle of Willis, thrombosis also may lead to bilateral infarction.Case Description A 73-year-old right-handed man presented with a complete loss of communicative behavior and an almost complete quadriplegia.99m Tc-hexamethylpropyleneamine oxime single-photon emission-computed tomography (HMPAO SPECT) of the brain showed a "horseshoe" image, reflecting bilateral perfusion defects in areas supplied by the anterior cerebral arteries. Postmortem examination of the brain revealed an unusual anomaly of the circle of Willis in B ilateral infarction in the anterior cerebral artery vascular territory is very rare 1 and usually results from rupture of an aneurysm of the anterior communicating artery or from thrombosis of the precommunicating part of the anterior cerebral artery in combination with an agenesis of the contralateral part. 2 We present a patient in whom bilateral infarction occurred because of thrombosis of the postcommunicating part of the left anterior cerebral artery and in whom the postcommunicating part of the right anterior cerebral artery was absent.
Case ReportA 73-year-old right-handed man was admitted to the hospital after he was found at home sitting in a chair in a verbally unresponsive state and unable to move a single limb. According to his daughter, he had experienced several transient episodes of weakness alternating in both legs during the weeks before admission. On admission the patient looked around and frowned when he was spoken to. He did not react differently to verbal commands and made no attempts to speak or utter sounds. Neurological examination revealed flaccid right hemiplegia, flaccid plegia of the left leg, and paresis of the left arm with an intact grip function of the hand.
scite is a Brooklyn-based organization that helps researchers better discover and understand research articles through Smart Citations–citations that display the context of the citation and describe whether the article provides supporting or contrasting evidence. scite is used by students and researchers from around the world and is funded in part by the National Science Foundation and the National Institute on Drug Abuse of the National Institutes of Health.