Successful Intra-Arterial Thrombolysis and Stenting in an Acute Ischemic Stroke Patient Caused by Anterior Cerebral Artery (ACA) Dissection with Occlusion

Abstract

Ischemic stroke is a major cause of death and disability in China and worldwide. Many reasons can cause stroke, including atherosclerosis, artery embolization, and cervical artery dissection and so on. Among them, spontaneous intracerebral artery dissection is a rare cause of acute ischemic stroke. Here we present a case of anterior cerebral artery (ACA) dissection with occlusion causing cerebral infarction, and successfully cured by arterial thrombolysis and stenting. A 60-year-old man was admitted because of ischemic stroke. Imaging examination showed that the proximal A2 segment of the right ACA was occluded, suggesting an occlusive infarction of the right anterior cerebral artery. After emergency intravenous thrombolysis, the symptoms of patient were relieved, but the symptoms aggravated again one hour later. Emergency DSA was performed, and the symptoms were improved after arterial thrombolysis and stenting. After 10 days, CT showed that the right cerebral infarction area was slightly limited than before. 1 month later, the symptoms were significantly improved, the patient could walk independently, and was discharged 42 days after the onset of the disease.