TS is a genetic disorder caused by partial or complete monosomy of X chromosome, usually the result of a sporadic chromosomal non-disjunction. There are only a few reported cases of ischemic stroke in TS but stroke due to isolated intracranial artery dissection has not been reported yet.

A 34-year-old woman with turner syndrome and diabetes mellitus was referred to our hospital with symptoms of left hemiparesis, developed post emergency exploratory laparotomy and appendectomy done for ruptured appendix. Post-op, she was difficult to arouse and had left side weakness. Her CT head was normal, MRI showed diffusion restriction on Right MCA territory with FLAIR mismatch and MRA was suspicious for Right MCA occlusion. She was intubated and referred to out hospital.

Her NIHSS was 10 (Level of consciousness 1, partial gaze palsy 1, motor function left arm 3, motor function left leg 4, sensory 1).

Patient was taken to the endovascular catheter lab. After DSA, it was found that the patient actually has a right M1 segment flow-limiting arterial dissection . Mechanical thrombectomy of the right M1 segment with suspected thrombus and successful intracranial stenting was done with TICI3 reperfusion.

TS presents with a myriad of complications with cardiovascular disease as a cardinal trait. Ischemic stroke(IS) is not well documented . The documented etiologies of ischemic stroke in TS are fibromuscular dysplasia, congenital hypoplasia of the carotid artery, extracranial artery dissections of vertebral artery and carotid artery while isolated intra-cranial artery dissections have never been reported.

The dissection post-surgery is suggestive of sympathetic overactivity playing a role in the etiology of IS. The acute sympathetic surge perhaps caused shear stress on the defective collagenous cerebral arteries causing dissection