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Unusually prolonged progressing stroke: an expanding anterior cerebral artery infarction
Hakan Ay1, Kayihan Uluç, Ethem M Arsava
1Department of Neurology, Hacettepe University Hospital, Ankara, Turkey. ayhmgh@hotmail.com
Abstract:
Progressive clinical deterioration over a period of weeks coupled with MRI evidence of infarction growth is quite uncommon. In this report, we describe a patient with an occluded left anterior cerebral artery (ACA) at the origin of the A2 segment. His symptoms attributable to a posteriorly located small infarction within the ACA territory slowly progressed during the following 8 weeks. A follow-up MRI revealed that the infarction had expanded to involve the whole region of the left ACA. Occasional patients like ours indicate that stroke is a dynamic disorder with an extremely variable clinical course and state of tissue injury.
Insights
A rare case shows a stroke expanding over 8 weeks, demonstrating that brain infarction can grow over time. This highlights the dynamic and variable nature of stroke progression and tissue injury.
Area of Science:
- Neurology
- Neuroimaging
- Vascular Neurology
Background:
- Stroke is typically considered a static event after initial insult.
- Rapid or progressive infarction growth is uncommon but documented.
Observation:
- A patient presented with progressive neurological decline over 8 weeks.
- Initial MRI showed a small posterior infarction in the left anterior cerebral artery (ACA) territory.
- Follow-up MRI revealed significant expansion of the infarction.
Findings:
- The left anterior cerebral artery (ACA) occlusion at the A2 segment led to a slowly progressing infarction.
- The infarction size increased substantially over an 8-week period.
- This case illustrates delayed and progressive infarction growth.
Implications:
- Stroke can be a dynamic process with evolving tissue injury.
- This variability challenges conventional understanding of stroke timelines.
- Further research into mechanisms of delayed infarction expansion is warranted.