Dissection extending from extra- to intracranial arteries: A case report of progressive ischemic stroke

We reported a rare case of 33-year-old patient with progressive ischemic stroke due to dissection from an intimal tear in the right proximal internal carotid artery to distal middle cerebral artery. Diagnoses: 3D fat-saturated T1 VISTA imaging, owing to its comprehensive neck and head coverage, high spatial resolution, enables the reader to have several sections with good contrast covering the dissected arterial segment, even in the rare dissection involving extra- and intra-cranial arteries referred in this article. Interventions: Clopidogrel 75mg daily was prescribed, also the patient was given rehabilitation training. Outcomes: His symptoms improved gradually. Lessons: We describe that 3D fat-saturated T1 VISTA was helpful for the diagnosis and follow-up in our case of cervicocephalic artery dissection complicated with progressive ischemic stroke. However, for totally acute occlusion of the artery without typical features of dissection, the unequivocal distinction between intramural haematoma and intraluminal thrombus may still be difficult with 3D fat-saturated T1 VISTA alone. Future studies should investigate whether an optimal VISTA technique would be useful for making a definite diagnosis.
Source: Medicine - Category: Internal Medicine Tags: Research Article: Clinical Case Report Source Type: research