Türk Beyin Damar Hast Derg. 2012; 18(3): 87-90 | DOI: 10.5505/tbdhd.2012.18209

An internal cerebral artery dissection presented with anterior choroidal artery infarction

Eda Kýlýç Çoban, Nilüfer Kale Ýçen, Aysun Soysal
Bakýrköy Mental Health Hospital 3rd Neurology Clinic, Ýstanbul

Anterior choroidal artery (AchA) is a branch of internal carotid artery. AchA infarcts are frequently presented by lacunar syndromes. Hemiparesis is the most common presenting symptom. Horner syndrome and cranial nerve palsies are unusual findings for AChA infarcts. In case of presentation with these, etiopathogenesis should be reconsidered and re-evaluated. A 42 year old man was admitted to our neurology clinic with right hemiparesis. He had Horner syndrom and hypoglossal nerve palsy. An acute AChA infarction was seen in cranial and diffusion-weighted magnetic resonance imaging (MRI). As there was a suspicious sign of carotid dissection in extracranial MR angiography, digital substraction angiography was performed and dissection of left carotid artery in the subpetrosal region was observed. The patient was diagnosed with left carotid artery dissection and was started on oral anticoagulan therapy. Presentation of an acute AChA infarction due to the dissection of ICA is rarely observed. ICA dissections can sometimes be presented by Horner syndrome and/or cranial nerve palsies. Especially in young stroke patients, dissection should be considered even if the
patient does not mention headache.

Keywords: Horner syndrome, carotid dissection, anterior choroidal artery infarct, hypoglossal nerve

---

Anterior koroidal arter enfarktý ile prezente olan bir internal serebral arter diseksiyonu

Eda Kýlýç Çoban, Nilüfer Kale Ýçen, Aysun Soysal
Bakýrköy Ruh Ve Sinir Hastalýklarý Eðitim Ve Araþtýrma Hastanesi 3. Nöroloji Kliniði, Ýstanbul

Anterior koroidal arter ( AChA) internal karotis arterin (ICA) dalý olup en sýk laküner sendrom kliniði ile prezente olur. En sýk gözlenen nörolojik bulgu hemiparezidir. Horner
sendromu ve alt kranyal sinir felçleri izole AChA enfarktlarý için beklenen bulgular deðildir. Bu klinikle karþýlaþýlan AChA enfarktý olan hastada altta yatan etyolojik neden gözden geçirilmelidir. 42 yaþýnda erkek hasta hastanemiz nöroloji kliniðine sað hemiparezi nedeni ile yatýrýldý. Nörolojik muayenesinde Horner sendromu ve hipoglossal sinir felci tespit edildi. Kranyal ve Difüzyon Magnetik rezonans görüntülemesinde (MR) sol AChA alanýnda akut enfarktý gözlendi. Ekstrakranyal MR Anjiografisinde sol ÝCA distal servikal ve proksimal petrozal kesiminde fokal kalibrasyon incelmesi tespit edilmesi üzerine hastaya Dijital Substraksiyon Anjiografisi (DSA) yapýldý. Sol ÝCA subpetröz segmentte diseksiyon tespit edildi. Hastaya oral antikoagülan tedavi baþlandý. ICA diseksiyonu Horner sendromu ve/veya alt kranyal sinir felçleri ile sýk olmasa da karþýmýza çýkabilir. Özellikle genç hastalarda travma ya da boyun aðrýsý anamnezi alýnmasa bile diseksiyon mutlaka akla gelmesi gereken neden olmalýdýr.

Anahtar Kelimeler: Horner sendrom, karotis diseksiyon, hipoglossal sinir, anteriyor koroidal arter enfarktý

---

CITE