Two cases of spontaneous middle cerebral arterial dissection causing ischemic stroke

Prognosis of intracranial dissection relates to site and presenting features

“…doi:10.1016/j.jocn.2010.11.006 internal carotid artery (ICA) dissection are rare, most comprising up to about 10 patients. [1][2][3][4] Intracranial dissection is, however, a clinically significant condition that causes severely disabling ischaemic stroke or subarachnoid haemorrhage (SAH), and is thought to carry a worse neurological prognosis than extracranial dissection. It has possibly been under-reported, but there is increased recognition with advances in non-invasive angiographic procedures.…”

Intracranial versus Extracranial Artery Dissection Cases Presenting with Ischemic Stroke

“…MRI was able to detect intramural hematoma (Fig 1, A), and MRA and its source imaging were able to display an intimal flap or double lumen (Fig 1, B). 23,24 A reason that IADs were detected more frequently in this study may be that cranial MRI and MRA were performed on most stroke patients in our department following the protocol of stroke diagnosis unless contraindications were present.…”

MCA Dissection Presenting with Intracerebral and Subarachnoid Hemorrhage

“…Isolated MCA dissection is a rare entity and its etiologies, clinical manifestations, natural history and prognosis remain poorly understood. Isolated MCA dissection is associated with more fluctuating course [4]. It may present with localized warning symptoms ipsilateral to the diseased vessel in the form of pain in the head or neck and disturbed sympathetic activity of the face [5].…”