Ischaemia-induced vascular vulnerability resulting in intracerebral haemorrhage with ipsilateral internal carotid artery occlusion

Neurol Sci. 2008 Oct;29(5):367-9. doi: 10.1007/s10072-008-0998-y. Epub 2008 Oct 21.


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.

Publication types

  • Case Reports

MeSH terms

  • Aged
  • Carotid Artery Diseases / complications*
  • Carotid Artery Diseases / diagnosis
  • Cerebral Angiography
  • Cerebral Hemorrhage / complications*
  • Cerebral Hemorrhage / diagnosis
  • Functional Laterality
  • Humans
  • Ischemia / complications*
  • Ischemia / diagnosis
  • Male
  • Tomography, X-Ray Computed