Ischaemia-induced vascular vulnerability resulting in intracerebral haemorrhage with ipsilateral internal carotid artery occlusion |
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Authors: | Motomasa Furuse Wakabayashi Shinichi Yoshio Suyama Kenkichi Takahashi Hiroshi Kajikawa |
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Affiliation: | (1) Department of Neurosurgery, Kitano Hospital, The Tazuke Kofukai Medical Research Institute, 2-4-20 Ohgimachi, Kita-ku, Osaka 530-8480, Japan;(2) Department of Neurosurgery, Suiseikai Kajikawa Hospital, Hiroshima, Japan |
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Abstract: | Intracerebral haemorrhage accompanied with cervical internal carotid artery (ICA) occlusion on the same side without moyamoya-like vessels is rare. A 73-year-old man with left ICA occlusion and no presence of moyamoya disease criteria underwent xenon-enhanced computed tomography with acetazolamide challenge test. The findings showed hypoperfusion and no vasoreactivity in the territory of the left middle cerebral artery. During follow-up he suffered bleeding in the left frontoparietal lobe. Cerebral angiography showed left ICA occlusion and cross flow via the anterior communicating artery without moyamoya vessels. Long-term ischaemia would make perforating or anastomotic arteries vulnerable. These arteries were easily ruptured by hypertension, resulting in intracerebral haemorrhage. |
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Keywords: | Acetazolamide Hypoperfusion Internal carotid artery occlusion Intracerebral haemorrhage |
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