Low pulsatile or non-pulsatile cerebral perfusion was noted in patients with aortic arch dissection,acute proximal internal carotid or common carotid artery occlusion and it means impending largecerebral infarction. A 45-year-old man had a sudden aphasia and left hemispheric symptoms withthe National Institutes of Health Stroke Scale score of 16 on arrival. Complete occlusion of left middlecerebral artery (MCA) with leptomeningeal collateral circulation from left anterior and posteriorcerebral artery was observed on transfemoral cerebral angiography. After chemical and mechanicalthrombolysis, occlusion of left MCA was partially recanalized. Transcranial Doppler showed anon-pulsatile waveform in left middle cerebral artery. In this case, non-pulsatile cerebral perfusion resultsfrom MCA lesion, which is more distal rather than proximal occlusion of carotid artery and aorticarch dissection. Therefore, this report noticed that non-pulsatile cerebral perfusion does not alwayspoint proximal source of arterial flow obstruction.

Journal of Neurosonology 4(1):19-21, 2012
Key Words: Acute stroke, Middle cerebral artery, Non-pulsatile cerebral perfusion