[Cerebral infarction and subarachnoid hemorrhage caused by dolichoectasia; report of a case]

Dolichoectasia usually causes neurological symptoms because of the pressure it exerts on adjacent intracranial structures and/or impaired circulation distal to ectasia. However, it rarely induces subarachnoid hemorrhage. The authors report just such a rare case of dolichoectasia, which caused subarachnoid hemorrhage following extensive cerebral infarction distal to ectasia. On October 18, 1982, a 47-year-old man came to our hospital with dementia which had started 7 days before, as his chief complaint. Neurological examinations revealed no positive findings. However, plain CT scan showed the presence of small multiple low density areas with a round-shaped high density area at the tip of the right temporal lobe. Angiogram taken on February 18, 1983, revealed that all main cerebral arteries, especially the C1 portion of the right internal carotid artery, and the M1 portion of the right middle cerebral artery were abnormally tortuous and distended. There was also pooling of contrast medium in the distal part of the M1 portion of the right middle cerebral artery which corresponded to the site of high density area on the plain CT scan. On January 31, 1987, he was admitted to our hospital with his chief complaint being the sudden onset of weakness in his left extremities. On admission, he was confused (II-10 on the Japan Coma Scale), dysarthric, and hemiparetic on the left side. Plain CT scan showed extensive cerebral infarction of the right middle cerebral artery territory distal to the ectasia.(ABSTRACT TRUNCATED AT 250 WORDS)