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Gangliocapsular Bleed with Ipsilateral Internal Carotid Artery Aplasia.

Mookan SK, Sundaram S, Rajagopalan N - Pol J Radiol (2015)

Bottom Line: In this scenario, an associated ipsilateral basal ganglia bleeding with subarachnoid haemorrhage with no aetiology is uncommon.Angiography revealed unilateral aplasia of the internal carotid artery.Patient improved symptomatically with a motor system power of grade 4 after hematoma evacuation and treatment with antibiotics, anti-edema measures and neuroprotective drugs.

View Article: PubMed Central - PubMed

Affiliation: Department of Radiology, Vinayaka Missions Kirupananda Variyar Medical College and Hospital, Salem, Tamilnadu, India.

ABSTRACT

Background: Agenesis requires an extensive work-up as a number of associated other vascular and nonvascular anomalies can be expected. In this scenario, an associated ipsilateral basal ganglia bleeding with subarachnoid haemorrhage with no aetiology is uncommon. We present such a case of moderate ipsilateral ganglio-capsular bleed of unknown cause with associate aortic arch vessel anomaly.

Case report: A 45-year-old diabetic man of Indian origin with complaints of a sudden onset of giddiness, left-sided weakness and slurring of speech. Motor system examination revealed power of grade 2. Computed tomography scan revealed a moderate bleeding in the basal ganglia and the right temporo-parietal lobe. Angiography revealed unilateral aplasia of the internal carotid artery. Patient improved symptomatically with a motor system power of grade 4 after hematoma evacuation and treatment with antibiotics, anti-edema measures and neuroprotective drugs.

Conclusions: Developmental anomalies of the carotid and aortic arch with intracranial bleeding is a rare occurrence and any arterial anomaly requires extensive evaluation.

No MeSH data available.


Related in: MedlinePlus

Ipsilateral middle cerebral artery being supplied by posterior circulation through the posterior communicating artery.
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f3-poljradiol-80-398: Ipsilateral middle cerebral artery being supplied by posterior circulation through the posterior communicating artery.

Mentions: A 45-year-old man of Indian origin was brought to our hospital with a history of sudden onset of giddiness and fall, following which he had left-sided weakness and slurring of speech. The patient is a known diabetic for 8 years and he was under treatment with an oral hypoglycaemic agent (Metformin 500 mg twice daily). No history of hypertension. The patient is a known alcoholic and smoker for about 15 years. On general examination, his pulse rate was 86/min and blood pressure was 140/90 mmHg. Auscultation revealed normal cardiovascular and respiratory systems. On palpation, the abdomen was soft, no tenderness, no organomegaly. On auscultation, bowel sounds were normal. The patient was conscious, drowsy, pupils were equal and reacting to light. Left upper motor neuron palsy and left hemiplegia were noted with a power of grade 2 during motor system examination. Biochemical investigations revealed normal parameters. Computed tomography (Figure 1) revealed a moderate bleeding in the basal ganglia and the right temporo- parietal lobe causing a mass effect in the right lateral ventricle and a midline shift of 5 mm to the left. There was diffuse subarachnoid haemorrhage in the basal cistern, tentorial leaflets, interhemispheric fissure, and temporo-parietal lobe. Angiography revealed unilateral aplasia of the Internal Carotid Artery (ICA) (Figure 2). Ipsilateral middle cerebral artery (MCA) was supplied by posterior circulation through the posterior communicating artery (Figure 3). Common origin of the right innominate artery and the left common carotid artery was seen (Figure 4). The MCA branches were compressed by the hematoma with the presence of vasospasm in the MCA branches and anterior cerebral arteries (ACA). No aneurysm or arteriovenous malformation pathology was identified.


Gangliocapsular Bleed with Ipsilateral Internal Carotid Artery Aplasia.

Mookan SK, Sundaram S, Rajagopalan N - Pol J Radiol (2015)

Ipsilateral middle cerebral artery being supplied by posterior circulation through the posterior communicating artery.
© Copyright Policy - open-access
Related In: Results  -  Collection

Show All Figures
getmorefigures.php?uid=PMC4554361&req=5

f3-poljradiol-80-398: Ipsilateral middle cerebral artery being supplied by posterior circulation through the posterior communicating artery.
Mentions: A 45-year-old man of Indian origin was brought to our hospital with a history of sudden onset of giddiness and fall, following which he had left-sided weakness and slurring of speech. The patient is a known diabetic for 8 years and he was under treatment with an oral hypoglycaemic agent (Metformin 500 mg twice daily). No history of hypertension. The patient is a known alcoholic and smoker for about 15 years. On general examination, his pulse rate was 86/min and blood pressure was 140/90 mmHg. Auscultation revealed normal cardiovascular and respiratory systems. On palpation, the abdomen was soft, no tenderness, no organomegaly. On auscultation, bowel sounds were normal. The patient was conscious, drowsy, pupils were equal and reacting to light. Left upper motor neuron palsy and left hemiplegia were noted with a power of grade 2 during motor system examination. Biochemical investigations revealed normal parameters. Computed tomography (Figure 1) revealed a moderate bleeding in the basal ganglia and the right temporo- parietal lobe causing a mass effect in the right lateral ventricle and a midline shift of 5 mm to the left. There was diffuse subarachnoid haemorrhage in the basal cistern, tentorial leaflets, interhemispheric fissure, and temporo-parietal lobe. Angiography revealed unilateral aplasia of the Internal Carotid Artery (ICA) (Figure 2). Ipsilateral middle cerebral artery (MCA) was supplied by posterior circulation through the posterior communicating artery (Figure 3). Common origin of the right innominate artery and the left common carotid artery was seen (Figure 4). The MCA branches were compressed by the hematoma with the presence of vasospasm in the MCA branches and anterior cerebral arteries (ACA). No aneurysm or arteriovenous malformation pathology was identified.

Bottom Line: In this scenario, an associated ipsilateral basal ganglia bleeding with subarachnoid haemorrhage with no aetiology is uncommon.Angiography revealed unilateral aplasia of the internal carotid artery.Patient improved symptomatically with a motor system power of grade 4 after hematoma evacuation and treatment with antibiotics, anti-edema measures and neuroprotective drugs.

View Article: PubMed Central - PubMed

Affiliation: Department of Radiology, Vinayaka Missions Kirupananda Variyar Medical College and Hospital, Salem, Tamilnadu, India.

ABSTRACT

Background: Agenesis requires an extensive work-up as a number of associated other vascular and nonvascular anomalies can be expected. In this scenario, an associated ipsilateral basal ganglia bleeding with subarachnoid haemorrhage with no aetiology is uncommon. We present such a case of moderate ipsilateral ganglio-capsular bleed of unknown cause with associate aortic arch vessel anomaly.

Case report: A 45-year-old diabetic man of Indian origin with complaints of a sudden onset of giddiness, left-sided weakness and slurring of speech. Motor system examination revealed power of grade 2. Computed tomography scan revealed a moderate bleeding in the basal ganglia and the right temporo-parietal lobe. Angiography revealed unilateral aplasia of the internal carotid artery. Patient improved symptomatically with a motor system power of grade 4 after hematoma evacuation and treatment with antibiotics, anti-edema measures and neuroprotective drugs.

Conclusions: Developmental anomalies of the carotid and aortic arch with intracranial bleeding is a rare occurrence and any arterial anomaly requires extensive evaluation.

No MeSH data available.


Related in: MedlinePlus