Subarachnoid hemorrhage after an ischemic attack due to a bacterial middle cerebral artery dissecting aneurysm: Case report and literature review

Atsushi Saito, Tomohiro Kawaguchi, Emiko Hori, Masayuki Kanamori, Shinjitsu Nishimura, Seiya Sannohe, Mitsuomi Kaimori, Tatsuya Sasaki, Michiharu Nishijima

Research output: Contribution to journalArticlepeer-review

6 Citations (Scopus)

Abstract

A 78-year-old woman suffered sudden-onset left hemiparesis. There were no remarkable infectious findings. Computed tomography (CT) demonstrated a low-intensity area supplied by the right middle cerebral artery (MCA). The diagnosis was cerebral ischemia and she was conservatively treated with hyperosmotic fluids. Two days after the ischemic stroke she suddenly became comatose. CT showed diffuse subarachnoid hemorrhage (SAH) in the basal cistern associated with a right intra-Sylvian and a right frontal subcortical hematoma. Three-dimensional (3D)-CT angiography demonstrated occlusion of the M2 portion of the right MCA. Four days after the ischemic onset she died of brain herniation. Autopsy revealed arterial dissection in the intermediate membrane of the right MCA bifurcation and occlusion of the M2 portion of the thrombosed right MCA. Gram staining showed remarkable bacterial infection in the thrombus. SAH after an ischemic attack due to MCA dissection is extremely rare. We suspect that bacterial infection was involved in the formation of her fragile dissecting aneurysm.

Original languageEnglish
Pages (from-to)196-200
Number of pages5
JournalNeurologia medico-chirurgica
Volume54
Issue number3
DOIs
Publication statusPublished - 2014

Keywords

  • Bacterial aneurysm
  • Cerebral infarction
  • Dissection
  • Subarachnoid hemorrhage

ASJC Scopus subject areas

  • Surgery
  • Clinical Neurology

Fingerprint Dive into the research topics of 'Subarachnoid hemorrhage after an ischemic attack due to a bacterial middle cerebral artery dissecting aneurysm: Case report and literature review'. Together they form a unique fingerprint.

Cite this