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A quadruple spontaneous dissection of cervicocerebral arteries

Sirs, Cervical arterial dissections are an important cause of ischemic stroke amongst young adults. Multiple vessel involvement accounts for 20–30% of all cases [1] although the simultaneous dissection of the four principal vessels is extremely rare, generally described in patients with an obvious trauma, fibromuscular dysplasia or other vasculopathies [2]. We report on a female patient with neither predisposing factors nor a clearly identifiable structural arteriopathy who suffered a simultaneous dissection of the four cervico-cerebral trunks with angiographic distinct findings [3,4]. A 37-year-old woman, with no history of migraine, hypertension, heart disease, oral contraceptives consumption, smoking