[Middle cerebral arterial occlusion secondary to brain tumor -- case report (author's transl)]

A thirty-year-old man who had sudden onsets of unconsciousness, right hemiparesis and conjugate deviation to the left side, was admitted to our clinic. The clinical symptoms were similar to an apoplexic attack. The neurologic examination showed right hyperactive knee and ankle reflexes, and left inferior temporal retinal arterial occlusion. The serial left carotid angiography, performed immediately after admission, showed the occlusion of left middle cerebral artery at the location of trifurcation. We diagnosed this case as a cerebral vascular disease, and then the large amount of Urokinase and Heparin were injected immediately after the diagnosis. The clinical symptoms were improved tremendously after the injection. Three days later, the second left carotid angiography showed the complete recanalization of the occlusion, and further did a tumor stain at the distal portion of the occlusion. The brain scintigram revealed an increased up-take of 99mTc in the left parieto-temporal region. We finally diagnosed brain tumor, and the tumor was subtotally removed by the left parieto-temporal craniotomy. The histological findings of the tumor showed angioblastic meningioma. The cerebral arterial occlusion secondary to the brain tumor should be caused by the compression of the vessels and the hemorrhage of the tumor. This case is rarely reported.