Corkscrew angiopathy of intracranial vessels in a young stroke patient: a case report

Abstract

Introduction: We present a rare finding of a 'corkscrew appearance' of the distal cerebral vessels in a young Asian woman who presented with acute stroke.

Case presentation: A 32-year-old Asian woman presented with a 3-month history of recurrent right-sided transient ischemic attacks. Her clinical workup and brain imaging results were normal. A digital subtraction angiogram revealed an abnormal corkscrew appearance of all intracranial distal vessels. She was discharged on a single antiplatelet drug. She had no further transient ischemic attacks on clinical follow-up. A digital subtraction angiogram performed 1 year later revealed no changes in the appearance of these vessels.

Conclusion: To the best of our knowledge no similar previous reports exist in the literature. The present report describes a unique case of an unusual corkscrew appearance of the distal intracranial vessels. However, the underlying etiology in the present case remains unknown.

Figure 1

Vertebral angiogram. Vertebral angiogram showing the abnormal pattern of the distal vessels of the posterior circulation in both (A) anteroposterior and (B) lateral projections.

Figure 2

Right internal carotid artery angiogram. Digital subtraction angiogram showing the corkscrew appearance of the intracranial small vessels of the right internal carotid angiogram in (A) anteroposterior and (B) lateral projections.

Figure 3

Left internal carotid artery angiogram. Digital subtraction angiogram showing corkscrew appearance of the distal small vessels of the left internal carotid angiogram in (A) anteroposterior and (B) lateral projections.