Challenging the diagnosis of a posterior circulation dissecting aneurysm.
Aneurysm sac thrombosis
Arterial intracranial dissection
Dissection aneurysm
Ischemic stroke
Journal
Neurological sciences : official journal of the Italian Neurological Society and of the Italian Society of Clinical Neurophysiology
ISSN: 1590-3478
Titre abrégé: Neurol Sci
Pays: Italy
ID NLM: 100959175
Informations de publication
Date de publication:
May 2022
May 2022
Historique:
received:
19
01
2022
accepted:
27
01
2022
pubmed:
10
2
2022
medline:
22
4
2022
entrez:
9
2
2022
Statut:
ppublish
Résumé
I ntracranial vertebral dissections have polymorphs clinical presentations and can lead to haemorrhagic complications if they are intracranial. We here describe a case of a thrombosed dissecting aneurysm of postero-inferior cerebellar artery (PICA) revealed by a Wallenberg syndrome preceded by headaches. A 23-year-old patient, without neurological or vascular past medical history, was admitted for dizziness preceded by headache. The clinical examination on admission revealed an incomplete Wallenberg syndrome, associating hemiface sensitive deficit, Horner's syndrome, dysmetria and nystagmus. The brain MRI showed a latero-medullary infarct with a homolateral PICA thrombosed dissecting aneurysm. The diagnosis of intracranial dissecting aneurysms needs particular caution because aneurysm sac thrombosis can give false reassurance on angiographic MR sequences. Moreover, the anatomic features of intracranial artery walls make them prone to sub-adventitial dissection and subsequent subarachnoid haemorrhages. Therefore, antithrombotic therapy should be used with caution, due to the risk of bleeding in these intracranial dissections.
Identifiants
pubmed: 35137349
doi: 10.1007/s10072-022-05923-1
pii: 10.1007/s10072-022-05923-1
doi:
Types de publication
Case Reports
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
3415-3417Informations de copyright
© 2022. Fondazione Società Italiana di Neurologia.
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