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Multimodality MRI and MRA for Decision Making in Minor Stroke: A Case with Internal Carotid and Distal Middle Cerebral Artery Occlusion
Author(s) -
Beitzke Markus,
Enzinger Christian,
Beitzke Dietrich,
Niederkorn Kurt,
Offenbacher Hans,
NiederkornDuft Margret,
Fazekas Franz
Publication year - 2011
Publication title -
journal of neuroimaging
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.822
H-Index - 64
eISSN - 1552-6569
pISSN - 1051-2284
DOI - 10.1111/j.1552-6569.2010.00501.x
Subject(s) - medicine , middle cerebral artery , thrombolysis , magnetic resonance imaging , occlusion , internal carotid artery , stroke (engine) , radiology , cardiology , perfusion scanning , anterior cerebral artery , magnetic resonance angiography , perfusion , ischemia , myocardial infarction , mechanical engineering , engineering
We report the case of a 65‐year‐old man who presented with mild, rapidly improving stroke symptoms. Acute magnetic resonance imaging disclosed no diffusion abnormalities but a tandem internal carotid artery/distal middle cerebral artery occlusion associated with a large corresponding deficit on perfusion imaging. In addition, there was a cross‐flow to the middle cerebral artery via the anterior communicating artery. Therefore, intravenous thrombolysis was initiated that led to rapid reopening of the middle cerebral artery and left the patient free of symptoms. Our observation highlights the possible benefit of systemic thrombolytic treatment even in the setting of an internal carotid artery occlusion and the substantial contribution of multimodal magnetic resonance imaging for a risk‐benefit estimate.