Reversible Segmental Dilatation of the Anterior Cerebral Artery

Kazui, Seiji; Kuriyama, Yoshihiro; Sawada, Tohru

doi:10.1159/000108723

Cited by 3 publications

(4 citation statements)

References 17 publications

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“…The other 3 had A2 segments which were initially dilated and then later restored to a normal state. As vascular changes in these cases were restricted to the ACA, and resolution of stenosis or occlusion has been considered a reliable angiographic sign of arterial dissection, they concluded that diagnoses of isolated ACA dissection seemed reasonable [11] . Our case presented a defi nite diagnosis, because the double lumen sign was demonstrated using 3D-RA.…”

Section: Discussionmentioning

confidence: 97%

3D-Rotational Angiographic Demonstration of Dissection of the Anterior Cerebral Artery

Matsumoto¹,

Takada²,

Kazui³

et al. 2005

Cerebrovasc Dis

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Section: Discussionmentioning

confidence: 97%

3D-Rotational Angiographic Demonstration of Dissection of the Anterior Cerebral Artery

Matsumoto¹,

Takada²,

Kazui³

et al. 2005

Cerebrovasc Dis

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“…Although the mechanisms remain unknown, the most likely etiologies are considered to be "reversible cerebral segmental vasoconstriction and dilatation," described by Call et al, 14 and isolated ACA dissections. 15 Reversible arterial lesions confined to the ACA may be important causes of ACA territory infarction.…”

Section: Discussionmentioning

confidence: 99%

Angiographic evaluation of brain infarction limited to the anterior cerebral artery territory.

Kazui

Sawada

Naritomi

et al. 1993

Stroke

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Background and Purpose: Brain infarction localized in the anterior cerebral artery territory is rather uncommon, and its etiology has not yet been fully elucidated.Methods: Based on computed tomographic findings, 17 patients with solitary anterior cerebral artery territory infarction were selected from among 3,619 patients admitted consecutively to our institute. Patients without angiographic examinations were excluded. The angiographic findings and clinical category of stroke were analyzed in each patient.Results: Angiographic abnormalities were revealed in all patients. These consisted of occlusive changes (#i=10) or reversible segmental dilatation (n=3) of the anterior cerebral artery, Al hypoplasia («=5), and occlusive changes of the carotid artery (n=3). In one patient with anterior cerebral artery occlusion, the occluded artery was reopened and subsequently became reoccluded. The clinical category of stroke was classified as atherothrombotic in 10 patients, cardioembolic in three, and undetermined in the remaining four. In eight of the 10 patients with atherothrombotic infarction, the anterior cerebral artery was narrowed or occluded. In all patients with cardioembolic infarction, the Al segment contralateral to the infarction was hypoplastic.Conclusions: In our series, solitary anterior cerebral artery territory infarction was attributable most commonly to local atherothrombosis and occasionally to cardiogenic embolism. A hypoplastic Al segment may facilitate the occurrence of embolism in the anterior cerebral artery. Reversible dilatatory and occlusive changes of this artery may be another important cause of infarction. (Stroke 1993;24:549-553) KEY WORDS • angiography • cerebral arteries • cerebral infarction

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“…Cerebral infarcts localized in the anterior cerebral artery (ACA) territory are relatively rare, representing 0.5– 3% of all ischemic strokes [1,2,3,4,5,6]. Large artery atherosclerosis is the leading etiology of ACA territory infarction [4,5].…”

Section: Introductionmentioning

confidence: 99%

“…All of these 3 patients were relatively young, had headache, and no previous history of stroke. For them, arterial dissection was regarded as the most plausible mechanism, but conclusive evidence was not obtained [6]. Several years afterwards, we succeeded in visualizing the pathognomonic findings of dissection, including the double lumen sign using 3-dimensional rotational angiography (3D-RA), which were not evident on MRA or conventional digital subtraction angiography (DSA) [7].…”

Section: Introductionmentioning

confidence: 99%

Isolated Anterior Cerebral Artery Territory Infarction: Dissection as an Etiological Mechanism

Sato¹,

Toyoda²,

Matsuoka³

et al. 2009

Cerebrovasc Dis

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Background: Intracranial arterial lesions are important causes of ischemic stroke, particularly in the Asian population. Of the intracranial lesions, the etiology of isolated anterior cerebral artery (ACA) territory infarction is not fully elucidated. The purpose of this study was to determine the etiological and clinical characteristics of patients with isolated ACA territory infarction, especially those with ACA dissection. Methods: Of 3,115 consecutive patients with acute ischemic stroke, 42 patients (1.3%, 30 men, 38–88 years old) having an isolated ACA territory infarction were studied. Infarcts were principally verified by diffusion-weighted MRI, and vascular lesions were identified by MRA, CTA, or digital subtraction angiography. Three-dimensional rotational angiography was performed if needed. Results: Eighteen patients (43%) were diagnosed as having ACA dissection. The stroke subtypes of the other 24 patients included cardioembolism for 6 patients and large-artery atherosclerosis for 8. Patients with dissection were younger (p < 0.001) and heavier (p = 0.026), less commonly had heart disease (p = 0.002) and previous stroke (p = 0.002), and had lower initial systolic blood pressure (p = 0.029) and lower levels of D-dimer (p = 0.041) than patients without dissection. Stroke onset more commonly followed physical exertion (p = 0.013) and headache (p = 0.041) in patients with dissection than in patients without dissection. At hospital discharge, the modified Rankin scale score was lower in patients with dissection than in patients without dissection (p = 0.005). Conclusions: Arterial dissection was the most common vascular lesion underlying an isolated ACA territory infarction in our Japanese cohort. Patients with ACA dissection had unique baseline characteristics and unique conditions at stroke onset.

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Reversible Segmental Dilatation of the Anterior Cerebral Artery

Cited by 3 publications

References 17 publications

3D-Rotational Angiographic Demonstration of Dissection of the Anterior Cerebral Artery

3D-Rotational Angiographic Demonstration of Dissection of the Anterior Cerebral Artery

Angiographic evaluation of brain infarction limited to the anterior cerebral artery territory.

Isolated Anterior Cerebral Artery Territory Infarction: Dissection as an Etiological Mechanism

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