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Updated: Jun 22, 2026
18:50
Microsurgical Clip Obliteration of Middle Cerebral Aneurysm Using Intraoperative Flow Assessment
Published on: September 25, 2009
Spontaneous middle cerebral arterial dissection presented with limb shaking
Yi-Chien Liu1, Chih-Ping Chung, Ping-Keung Yip
1Neurological Center, Cardinal Tien Hospital, Taipei, Taiwan.
Acta Neurologica Taiwanica
|June 23, 2009
Summary
Limb shaking may indicate spontaneous middle cerebral artery dissection (MCAD), a rare cause of ischemic stroke. Diagnosis involves MR imaging and Doppler sonography, highlighting limb shaking as a potential symptom of severe carotid occlusive disease.
Area of Science:
- Neurology
- Vascular Neurology
- Neuroimaging
Background:
- Middle cerebral artery dissection (MCAD) is an uncommon cause of ischemic stroke, typically presenting with headache and focal neurological deficits.
- Spontaneous arterial dissections, including MCAD, are increasingly recognized, particularly in younger populations.
Observation:
- This report details a young male patient experiencing significant limb shaking as a primary symptom of spontaneous MCAD.
- The patient's presentation deviated from the classic symptoms of headache and hemispheric deficits commonly associated with MCAD.
Findings:
- Diagnosis of MCAD was confirmed through direct visualization of intramural hematoma on MR T2-weighted images.
- Serial transcranial Doppler (TCD) sonography provided supportive evidence for the diagnosis and evolution of the dissection.
Implications:
- Limb shaking, often overlooked, can be a significant clinical manifestation of spontaneous MCAD.
- This case broadens the spectrum of symptoms associated with intracranial carotid occlusive disease, suggesting further investigation in patients with unexplained limb shaking.
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