Journal of Cerebrovascular and Endovascular Neurosurgery  2015;17(2):108-112

doi:10.7461/jcen.2015.17.2.108

Endovascular Treatment in Ruptured Middle Cerebral Artery Dissection Preservation of Arterial Continuity.

Dong Hyuk NAM 1 ; Sang Kyu PARK

Affiliations

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Keywords

Dissecting aneurysm; Middle cerebral artery; Flow diversion; Stent assisted coil embolization

Country

Republic of Korea

Language

English

Abstract

Rupture of spontaneous dissecting aneurysms of the middle cerebral artery (MCA) is rare and its etiology remains obscure, although the risk of rebleeding is greater than with saccular aneurysms. Most reports concerning the treatment of a ruptured dissecting aneurysm of the anterior circulation involve surgical trapping or wrapping. Here, we report on a case of an MCA dissecting rupture treated with endovascular procedures. A 22-year-old female presented with sudden stuporous mental change following severe headache and left side hemiparesis. A computed tomography scan showed a diffuse subarachnoid hemorrhage and diffusion MR showed diffusion restriction at the right putamen and internal capsule. A 3-hour follow-up digital subtraction angiography (DSA) showed a dissecting aneurysm, which was not seen on an initial DSA. A stent assisted coil embolization was performed and double stents were applied to achieve flow diversion effects. A small remnant area of the dissecting aneurysm had disappeared at 60-day and was not observed on 12-month follow-up DSA.