Intracranial supraclinoid ICA dissection causing cerebral infarction and subsequent subarachnoid hemorrhage

Naif M. Alotaibi, Jennifer E. Fugate, Timothy J. Kaufmann, Alejandro A. Rabinstein, Eelco F.M. Wijdicks, Giuseppe Lanzino

Research output: Contribution to journalArticle

3 Scopus citations

Abstract

Background: Intracranial arterial dissection usually leads to cerebral infarction or subarachnoid hemorrhage (SAH). It is rare to see both complications in one clinical scenario. Methods: Case report and review of the literature. Results: A 48-year-old woman suffered a left middle cerebral infarct from a dissection of the left supraclinoid ICA. As she was recovering from the ischemic stroke 5 days later she suffered a SAH. The SAH was caused by rupture of a dissecting pseudoaneurysm, which only became evident on repeat catheter angiography. The dissecting pseudoaneurysm was treated with coil occlusion. Conclusion: Intracranial ICA dissections are typically associated with either ischemic or hemorrhagic presentation. We report an unusual case of a patient who suffered a SAH a few days after an ischemic stroke from the dissection. This case contradicts the long-held dogma that intracranial dissection can have either an ischemic or a hemorrhagic presentation, but not both.

Original languageEnglish (US)
Pages (from-to)252-256
Number of pages5
JournalNeurocritical care
Volume18
Issue number2
DOIs
StatePublished - Apr 1 2013

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Keywords

  • Dissecting pseudoaneurysm
  • Internal carotid artery
  • Intracranial dissection
  • Ischemic stroke
  • Subarachnoid hemorrhage (SAH)

ASJC Scopus subject areas

  • Clinical Neurology
  • Critical Care and Intensive Care Medicine

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