Abstract
IntroductionSimultaneous bilateral cerebrovascular infarction is relatively rare and its initial presentation as a space-occupying lesion is extremely uncommon. However, bilateral infarction can result from unilateral occlusion of anomalous cerebral vasculature.Case presentationWe report the case of a man presenting with lower limb weakness and aphasia of acute onset with initial computerised tomography suggesting bifrontal neoplasm. However, further investigation confirmed bilateral anterior cerebral artery territory infarction with a hypoplastic left anterior cerebral artery with the right anterior cerebral artery supplying both frontal lobes (an anatomical variant). We present the clinical and diagnostic features of this presentation and attempt to ascertain, by reviewing existent medical literature, the frequency and patterns of structural variations in cerebral vasculature.ConclusionSimultaneous bilateral cerebral infarction can be the result of a unilateral cerebral artery occlusion and this can potentially mimic a space-occupying lesion. Anomalies of cerebral vasculature are not as rare as is usually believed and this should be borne in mind when investigating unusual presentations of cerebrovascular infarction.
Highlights
Simultaneous bilateral cerebrovascular infarction is relatively rare and its initial presentation as a space-occupying lesion is extremely uncommon
Simultaneous bilateral cerebral infarction can be the result of a unilateral cerebral artery occlusion and this can potentially mimic a space-occupying lesion
Anomalies of cerebral vasculature are not as rare as is usually believed and this should be borne in mind when investigating unusual presentations of cerebrovascular infarction
Summary
This case report highlights the finding that simultaneous bilateral cerebral infarction can be the result of a unilateral cerebral artery occlusion and that this can potentially mimic a space-occupying lesion. It demonstrates that anomalies of cerebral vasculature are not as rare as is usually believed, and this should be borne in mind when investigating unusual presentations of cerebrovascular infarction. ACA: anterior cerebral artery; CT: computerised tomography; DSA: digital subtraction angiography; ICA: internal carotid artery; MRI: magnetic resonance imaging
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