Ischemic Stroke in MCA Dissection with the Formation of the Double Lumen: Diagnostic Challenges

We describe a patient who experienced a right middle cerebral artery (MCA) stroke at the age of 12. Its clinical manifestations (acute onset of left-sided hemiparesis and headache during swimming) and signs of connective tissue weakness (joint hyperflexibility, increased skin elasticity) suggested r...

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Bibliographic Details
Main Authors: Ludmila A. Kalashnikova, Alexey S. Filatov, Marina V. Dreval
Format: Article
Language:English
Published: Research Center of Neurology 2025-06-01
Series:Анналы клинической и экспериментальной неврологии
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Online Access:https://annaly-nevrologii.com/pathID/article/viewFile/1125/pdf
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Summary:We describe a patient who experienced a right middle cerebral artery (MCA) stroke at the age of 12. Its clinical manifestations (acute onset of left-sided hemiparesis and headache during swimming) and signs of connective tissue weakness (joint hyperflexibility, increased skin elasticity) suggested right MCA dissection as the stroke cause. However, 1.5T MRI/MRA did not confirm the clinical suspicion: blood flow in the right MCA was preserved, and no intramural hematoma was detected. Only an irregular MCA contour was noted. High-resolution 3T MRI performed seven years later revealed a double lumen in the right MCA — a characteristic dissection sign — confirming the initial clinical hypothesis. This case demonstrates that when MCA dissection is clinically suspected as the cause of ischemic stroke, high-resolution MRI is necessary to verify neuroimaging signs of dissection.
ISSN:2075-5473
2409-2533