Traumatic dissection of the anterior cerebral artery secondary to a rugby related impact: A case report with emphasis on the usefulness of T1-VISTA.
| Autor: | Nakao J; Department of Stroke and Cerebrovascular Disease, University of Tsukuba Hospital., Hosoo H; Department of Neurosurgery, Faculty of Medicine, University of Tsukuba., Muroi A; Department of Neurosurgery, Faculty of Medicine, University of Tsukuba., Takahashi T; Department of Neurosurgery, University of Tsukuba Hospital., Marushima A; Department of Neurosurgery, Faculty of Medicine, University of Tsukuba., Ishikawa E; Department of Neurosurgery, Faculty of Medicine, University of Tsukuba., Matsumaru Y; Division of Stroke Prevention and Treatment, Department of Neurosurgery, Faculty of Medicine, University of Tsukuba, Tsukuba, Japan. |
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| Jazyk: | angličtina |
| Zdroj: | Surgical neurology international [Surg Neurol Int] 2023 Feb 03; Vol. 14, pp. 43. Date of Electronic Publication: 2023 Feb 03 (Print Publication: 2023). |
| DOI: | 10.25259/SNI_1082_2022 |
| Abstrakt: | Background: Cerebrovascular injuries (CVIs) are not usually considered in the differential diagnosis of sport-related head injuries (SRHIs). We encountered a rugby player with traumatic dissection of the anterior cerebral artery (ACA) after impact on the forehead. Head magnetic resonance imaging (MRI) with T1-volume isotropic turbo spin-echo acquisition (VISTA) was used to diagnose the patient. Case Description: The patient was a 21-year-old man. During a rugby tackle, his forehead collided with the forehead of an opponent. He did not have a headache or disturbance of consciousness immediately after the SRHI. On the 2 nd day of illness, he had transient weakness of the left lower limb several times. On the 3 rd day of illness, he visited our hospital. MRI revealed occlusion of the right ACA and acute infarction of the right medial frontal lobe. T1-VISTA revealed intramural hematoma of the occluded artery. He was diagnosed with acute cerebral infarction due to dissection of the ACA and was followed up for vascular changes with T1-VISTA. The vessel had recanalized and the size of the intramural hematoma had decreased 1 and 3 months after the SRHI, respectively. Conclusion: Accurate detection of morphological changes in cerebral arteries is important for the diagnosis of intracranial vascular injuries. When paralysis or sensory deficits occur after SRHIs, it is difficult to differentiate between concussion from CVI. Athletes with red-flag symptoms after SRHIs should not merely be suspected to have concussion; they should be considered for imaging studies. Competing Interests: There are no conflicts of interest. (Copyright: © 2023 Surgical Neurology International.) |
| Databáze: | MEDLINE |
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