Bilateral caudate nuclei infarctions following the unilateral left anterior cerebral artery occlusion

Abstract

Bilateral caudate nuclei infarctions are rare patterns of infarction. A 75-year-old female presented with acute abnormal behavior. She had atrial fibrillation. Brain computed tomography (CT) angiography showed non-visualization of the bilateral anterior cerebral arteries (ACAs). After using of intravenous recombinant tissue plasminogen activator (rt-PA), there were high signal intensities of the bilateral caudate nuclei on diffusion weighted magnetic resonance images and recanalization of the left ACA with hypoplasia of the A1 segment of the right ACA on conventional angiography. This case demonstrates the bilateral caudate nuclei infarctions can be induced by a single cardioembolic occlusion of the ACA in a patient with hypoplasia of the contralateral ACA.