We present a case report of a 13-year old girl who developed hemiparesis with central nerve VII palsy, sensorimotor aphasia and emotional disturbances. The described symptoms occured in health, patient experienced acute onset of left-side headache. Two day earlier she had paresthesies of the right upper limb. Computer tomography of brain was normal. Ultrasonography of carotid arteries in Doppler method revealed high flow on the left internal carotid artery. Cerebral arteriogram showed existing nearly complete occlusion of the middle left cerebral artery. Angio-MRI confirmed the stenosis of the middle left cerebral artery. MRI of brain showed the ischaemic focus of precentral gyrus and temporal pole of the left hemisphere. In laboratory tests alpha-1 antitripsin activity was decreased. After 3 weeks the anti-aggregation therapy, the improvement of cerebral metabolism and perfusion observed good clinical recovery. Minor symptoms of sensorimotor aphasia were persisted.

Keywords: middle cerebral artery dissection, Fibromuscular Dysplasia, alfa-1 antitrypsin deficiency