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Intracranial Supraclinoid ICA Dissection Causing Cerebral Infarction and Subsequent Subarachnoid Hemorrhage

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Abstract

Background

Intracranial arterial dissection usually leads to cerebral infarction or subarachnoid hemorrhage (SAH). It is rare to see both complications in one clinical scenario.

Methods

Case report and review of the literature.

Results

A 48-year-old woman suffered a left middle cerebral infarct from a dissection of the left supraclinoid ICA. As she was recovering from the ischemic stroke 5 days later she suffered a SAH. The SAH was caused by rupture of a dissecting pseudoaneurysm, which only became evident on repeat catheter angiography. The dissecting pseudoaneurysm was treated with coil occlusion.

Conclusion

Intracranial ICA dissections are typically associated with either ischemic or hemorrhagic presentation. We report an unusual case of a patient who suffered a SAH a few days after an ischemic stroke from the dissection. This case contradicts the long-held dogma that intracranial dissection can have either an ischemic or a hemorrhagic presentation, but not both.

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Authors and Affiliations

  1. Department of Neurologic Surgery, Mayo Clinic, 200 First Street SW, Rochester, MN, 55905, USA

    Naif M. Alotaibi & Giuseppe Lanzino

  2. Department of Neurology, Mayo Clinic, Rochester, MN, USA

    Jennifer E. Fugate, Alejandro A. Rabinstein & Eelco F. M. Wijdicks

  3. Department of Radiology, Mayo Clinic, Rochester, MN, USA

    Timothy J. Kaufmann

Authors
  1. Naif M. Alotaibi
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  2. Jennifer E. Fugate
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  3. Timothy J. Kaufmann
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  4. Alejandro A. Rabinstein
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  5. Eelco F. M. Wijdicks
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  6. Giuseppe Lanzino
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Correspondence to Giuseppe Lanzino.

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Alotaibi, N.M., Fugate, J.E., Kaufmann, T.J. et al. Intracranial Supraclinoid ICA Dissection Causing Cerebral Infarction and Subsequent Subarachnoid Hemorrhage. Neurocrit Care 18, 252–256 (2013). https://doi.org/10.1007/s12028-012-9781-2

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  • DOI: https://doi.org/10.1007/s12028-012-9781-2

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