[Occlusion of anterior and middle cerebral arteries after closed head injury: a case report].

We report a case of traumatic anterior and middle cerebral arteries occlusion. A 23-year-old man was admitted to our hospital following an automobile accident. He was comatose and had a small skin laceration on the left temporal region. The pupils did not react to light. CT scan revealed traumatic subarachnoid hemorrhage at the basal cistern and left sylvian fissure. His consciousness gradually recovered, but he became aphasic 4 days after the trauma. Cerebral angiography showed a irregularity of the left internal carotid artery at C1 portion and occlusion of left anterior and middle cerebral artery at A1 and M1 portion. CT scan showed low density area in the left middle cerebral artery distribution. Five months later, follow-up angiography disclosed recanalization of anterior and middle cerebral arteries. In our case, thrombus formation at C1 portion of left internal carotid artery might have occurred to result in the embolic occlusion of the anterior and middle cerebral arteries. To date, 34 cases of traumatic middle cerebral artery occlusion have been reported. However there have been only 2 cases which accompanied anterior cerebral artery occlusion.