Middle Cerebral Artery Dissection: A Report of Two Cases With Treatments and Outcomes.
| Autor: | Papiri G; Neurology Unit, Ospedale Provinciale Madonna del Soccorso, San Benedetto del Tronto, ITA., Bruni S; Interventional Neuroradiology, Ospedale Regionale Umberto I, Ancona, ITA., Puca E; Neurology Unit, Ospedale Provinciale Madonna del Soccorso, San Benedetto Del Tronto, ITA., Sanguigni S; Neurology Unit, Ospedale Provinciale Madonna del Soccorso, San Benedetto Del Tronto, ITA., Marcucci M; Radiology Unit, Ospedale Provinciale Macerata, Macerata, ITA. |
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| Jazyk: | angličtina |
| Zdroj: | Cureus [Cureus] 2023 May 29; Vol. 15 (5), pp. e39632. Date of Electronic Publication: 2023 May 29 (Print Publication: 2023). |
| DOI: | 10.7759/cureus.39632 |
| Abstrakt: | In the present report, we describe two cases of right-sided M1 segment middle cerebral artery dissection in a 51-year-old Asian female and in a 28-year-old Caucasian male patient with no previous history of ischemic stroke or known intracranial atherosclerosis presenting with acute unilateral headache progressing to severe multifocal hemispheric infarction with nearly complete one-sided motor paralysis. In both patients, a middle cerebral artery dissection was detected on angiography; they were given exclusively medical therapy: patient 1 was not eligible to reperfusive therapies and was treated with a three-month course of acetylsalicylic acid and clopidogrel combined with low-dose enoxaparin, while patient 2 was initially treated with intravenous alteplase with no hemorrhagic complications and was later shifted to single antiplatelet therapy. Despite an initial worsening of clinical severity and an extensive ischemic lesion in both patients, neurologic function improved over time, eventually allowing recovery of unaided gait. Therefore, in the absence of signs of hemorrhage, intravenous thrombolysis or dual antiplatelet regimens could be considered in strokes related to middle cerebral artery dissection. Competing Interests: The authors have declared that no competing interests exist. (Copyright © 2023, Papiri et al.) |
| Databáze: | MEDLINE |
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