True Aneurysm of the Superficial Temporal Artery

This is a case report of a 50-year-old female who presented to our clinic with headache and left temporal pulsatile mass. Aneurysm was revealed incidentally on a computed tomography angiography of her head. Open surgical resection with aneurysmal trapping was performed under local anesthesia. Histological examination demonstrated a true aneurysm of the superficial temporal artery. There was loss of normal elastin in the internal elastin layer. This case report describes the rare entity along with a review of the literature.

Bilateral Cerebellar Ataxia Due to an Unilateral Brain Stem Infarction

No abstract available.

Implications of a Variation of Middle Cerebral Artery in the Interpretation of Transcranial Doppler

The accessory middle cerebral artery (MCA) is a variation of the MCA branching, which originates from the anterior cerebral artery (ACA). It is deemed as an incidental anatomical finding and the incidence is reported to be 0.3% to 4.0%. Although the accessory MCA is infrequent it nevertheless may have important implications in the interpretation of transcranial Doppler (TCD) findings. We report two patients having an accessory MCA and its clinical significance.

Analysis of Ischemic Stroke Patterns Using the Diffusion-Weighted Imaging in Patients with Complicated Aortic Plaques

BACKGROUND: This study aimed at characterizing the lesion patterns in patients with acute ischemic stroke and complicated aortic plaques using the diffusion-weighted magnetic resonance imaging (DWI). METHODS: We retrospectively reviewed 403 consecutive patients with acute ischemic stroke between January 2002 and December 2004, and enrolled patients who had received a trans-esophageal echocardiography (TEE). All the patients should have an acute cerebral infarction within 7 days of the onset of symptoms. We analyzed the ischemic lesion patterns on DWI in the patients who had aortic atheroma protruded into the lumen greater than 4 mm in the aortic arch or ascending aorta (complicated aortic plaques; CAP). Ischemic lesions were classified into subcortical, cortical and multiple infarctions. We investigated the accompanying risk factors for atherosclerosis and stenosis of the relevant major brain artery as well. RESULTS: Of the 403 patients, TEE was performed in 210 (52%) and CAP was found in 25 (12%). Among 25 patients, subcortical infarction was observed in 15 (60%), followed by cortical infarction in 7 (28%), and multiple ischemic lesions in 3 (12%). CAP was frequently associated with hypertension and current smoking, and accompanied with stenosis of the relevant major brain artery as well (68%). CONCLUSIONS: CAP may be a potential source of embolism. However, the high prevalence of the small subcortical lesion in this study questions the mechanisms of ischemic stroke in patients with aortic atheroma. CAP may be an uncomplicated marker of advanced systemic atherosclerosis including the cerebral arteries.