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Updated: Sep 26, 2026
Middle Cerebral Artery Occlusion Allowing Reperfusion via Common Carotid Artery Repair in Mice
Published on: January 23, 2019
[Serial magnetic resonance images in patient with the middle cerebral artery dissection]
Masaki Watanabe1, Yuichiro Inatomi, Toshiro Yonehara
1Stroke Center, Saiseikai Kumamoto Hospital.
Abstract:
A 30-year-old man suffered from transient left hemiparesis and was admitted under the clinical diagnosis of transient ischemic attack. Cerebral angiogram on admission disclosed severe stenosis at the horizontal portion of the right middle cerebral artery. Magnetic resonance images (MRI) on axial view showed a linear enhanced lesion along the stenosis. Images on sagittal view disclosed a crescent-like lesion surrounding a flow void of the middle cerebral artery. After administration of aspirin, he had never suffered from hemiparesis. The enhanced lesion of the middle cerebral artery gradually disappeared on MRI. Although the middle cerebral artery showed temporary improvement of the stenotic lesion, it finally occluded 9 months after the onset. A diagnosis of spontaneous dissection of the right middle cerebral artery was made. The process of the arterial hemodynamics, such as a shrinking of the pseudo-lumen and a flow improvement in the true lumen, was well documented on serial MRI with Gd-DTPA and serial MRA.
Insights
Spontaneous dissection of the middle cerebral artery caused transient ischemic attack symptoms. Serial MRI revealed healing and eventual occlusion, highlighting the condition
Area of Science:
- Neurology
- Vascular Neurology
- Neuroradiology
Background:
- Transient ischemic attack (TIA) can be caused by various cerebrovascular pathologies.
- Middle cerebral artery stenosis requires accurate diagnosis and monitoring.
Observation:
- A 30-year-old man presented with transient left hemiparesis, diagnosed as TIA.
- Cerebral angiography revealed severe stenosis in the right middle cerebral artery.
- MRI demonstrated characteristic linear and crescent-like lesions consistent with dissection.
Findings:
- Aspirin administration resolved hemiparesis, and MRI showed lesion improvement.
- Despite initial improvement, the middle cerebral artery ultimately occluded after 9 months.
- Serial MRI and MRA documented dynamic changes in arterial hemodynamics, including pseudo-lumen shrinkage.
Implications:
- Spontaneous middle cerebral artery dissection is a critical diagnosis in young adults presenting with TIA.
- Serial imaging is crucial for monitoring disease progression and treatment response.
- Understanding the hemodynamic changes aids in managing cerebrovascular dissections.
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