Rinsho Shinkeigaku (Clinical Neurology)

Case Report

A case of intracranial arterial dolichoectasia with 4 repeated cerebral infarctions in 6 months and enlargement of basilar artery

Hideyuki Moriyoshi, M.D.1), Soma Furukawa, M.D.1), Mai Iwata, M.D.1), Junichiro Suzuki, M.D., Ph.D.1), Noriyoshi Nakai, M.D.1)2), Suguru Nishida, M.D.1) and Yasuhiro Ito, M.D., Ph.D.1)

1)Department of Neurology, Stroke Center, TOYOTA Memorial Hospital
2)Department of Stroke Treatment, Shonan Kamakura General Hospital Stroke Center

A 78-year-old man was admitted to our hospital because of sudden right hemiparesis and dysarthria. His cranial MRI showed an area of hyperintensity in left pons on DWI and MRA revealed dilated, elongated and tortuous intracranial artery. We diagnosed as acute phase ischemic stroke and intracranial arterial dolichoectasia (IADE). Intravenous infusion of rt-PA was performed 157 minutes after the onset of symptoms, and his hemiparesis improved. However, he subsequently suffered from cerebral infarction 4 times in 6 months, and we treated him twice with thrombolytic therapy. Although thrombolytic therapy was effective in the short term and antithrombotic therapy was continued, he had bilateral hemiplegia and severe dysphagia because of repeated cerebral infarctions. Hence basilar artery was dilated with intramural hemorrhage over 6 months, and we discontinued antithrombolytic therapy. It is possible that antithrombolytic therapy affects enlargement of IADE. Antithrombolytic therapy for IADE should be done carefully.
Full Text of this Article in Japanese PDF (673K)

(CLINICA NEUROL, 57: 124|129, 2017)
key words: intracranial arterial dolichoectasia, rt-PA, cerebral infarction, antithrombotic therapy, basilar artery

(Received: 18-Dec-16)