Posttraumatic Dissecting Aneurysm of the Anterior Cerebral Artery: Case Report

Abstract

A case of cerebral infarction in the territory of the anterior cerebral artery after a minor head injury is reported. It is possible that direct or mechanical damage by the edge of the falx or stretching and shearing of the anterior cerebral artery after an acute shift of the corpus callosum caused the localized lesion of the left anterior cerebral artery. We think that this mechanical injury caused a dissecting aneurysm or a cerebral arterial dissection, which was diagnosed by sequential angiographic changes.

Bilateral anterior cerebral infarcts from a depressed anterior base of skull fracture: Case report and review of the literature

“…32 Only one case of a dissecting aneurysm of the anterior cerebral artery after blunt trauma has been reported. 2 Other reports of occlusion after trauma have been described either after penetrating injury 10,23,27 or as a late manifestation after the development of an arterial aneurysm. 1,9 In the case we describe, the patient had an acute anterior cerebral artery injury after blunt head injury.…”

Dissecting Aneurysms at the A1 Segment of the Anterior Cerebral Artery. Two Case Reports.

“…33) All of these cases may harbor type II dissection. Alternatively, type II dissection may be clas- 30) 16/M infarction headache, congenital defect of dead nasal bleeding, the vessel wall lt hemiplegia, aphasia Scott et al (1960) 25) 29/F infarction lt hemiparesis, trauma (surgical dead lt facial nerve palsy, complication) aphasia Nedwich et al (1963) 18) 30/F infarction lt hemiparesis unknown dead Grosman et al (1980) 7) 23/M infarction dysphagia, unknown dead rt hemiparesis Adams et al (1982) 1) 75/F SAH headache unknown moderately disabled Steiner et al (1986) 26) 23/F infarction headache, congenital weakness dead lt hemiparesis, of elastic lamina semicoma Linden et al (1987) 15) 23/F infarction lt hemiplegia, coma unknown dead Kitani et al (1987) 13) 14/M infarction headache, unknown dead lt hemiplegia II Gherardi and Lee (1967) 6) 26/F SAH headache, coma unknown dead Nelson (1968) 19) 5/M infarction headache, trauma dead rt hemiparesis, aphasia Pilz (1977) 23) 22/F incidental Guillain-Barr áe dead syndrome Yamashita et al (1983) 31) 16/F incidental moyamoya disease ＋ dead trauma Honda et al (1997) 10) 48 2) 44/M infarction aphasia, trauma good rt hemiparesis recovery Sasaki et al (1991) 24) 57/M infarction headache, unknown moderately weakness of lt leg disabled Terai and Matsubara (1991) 29) 51/M infarction headache, unknown good rt hemiparesis recovery Guridi et al (1993) 8) 72/F SAH ＋ ICH headache, neck pain, arteriosclerosis moderately loss of consciousness, disabled rt hemiparesis Nomura et al (1993) 20) 37/M infarction headache, trauma good weakness of lt leg recovery …”

Reversible Segmental Dilatation of the Anterior Cerebral Artery

“…A search of the litera ture. however, has revealed only 3 previous cases of ischemic stroke with dilatatorv changes of the ACA [20][21][22]: 1 was postlraum aticand the others were spontaneous. Our 3 patients shared some common features as follows: (1) all of them were middle-aged adults.…”

“…While dissections were considered to occur less frequently in the intracranial arteries than in the extra cranial carotid artery, intracranial dissections have been increasingly reported in the MCA [28][29][30] and posterior circulation (31)(32)(33)(34). The ACAs could be compromised when dissections spread from the inter nal carotid arteries [35][36][37], Localized dissections o f the ACAs, how ever, have been reported in several cases [20][21][22][38][39][40]. Dissection occurs when blood extrudes into the arterial wall, often narrowing the true lumen and sometimes causing focal or diffuse dilatation [41] Although a double lumen is known to be a pathognomonic finding ol intracranial dissection [31,32], it has been reported to be extreme!)…”