scholarly journals Hit by the wave: a case of painful Horner’s and intramural haematoma of the carotid

2018 ◽  
pp. bcr-2018-225660
Author(s):  
Etimbuk Umana ◽  
Raazi Bajwa ◽  
Ian Davidson ◽  
David Gallagher
Keyword(s):  
Carotid Artery ◽  
Stroke Risk ◽  
Carotid Artery Dissection ◽  
Vasa Vasorum ◽  
Artery Dissection ◽  
Intramural Haematoma ◽  
History Of ◽  
The Right ◽  
Mr Brain ◽  
Mr Angiogram

Carotid artery dissection from rupture of the vasa vasorum is under-recognised. We report the case of a 60-year-old woman presenting to our hospital with a 2-week history of right-sided headache, neck pain, unequal pupils and ptosis after being hit by a wave on the beach. She was diagnosed with painful Horner’s syndrome. MR angiogram revealed dissection of the right internal carotid artery with an intramural haematoma without an intimal flap. A diagnosis of carotid artery dissection from rupture of the vasa vasorum was made. Initial antithrombotic (aspirin and clexane) were stopped as she was deemed a low stroke risk with no signs of ischaemia on MR brain. Her clinical course was uneventful with resolution of the intramural haematoma seen on repeat MR angiogram.

scholarly journals Ischemic Stroke Secondary to Stylocarotid Variant of Eagle Syndrome

2018 ◽  
Vol 9 (2) ◽  
pp. 105-108 ◽  
Author(s):  
Shakaib Qureshi ◽  
Muhammad U. Farooq ◽  
Philip B. Gorelick
Keyword(s):  
Ischemic Stroke ◽  
Carotid Artery ◽  
Styloid Process ◽  
Carotid Artery Dissection ◽  
Artery Dissection ◽  
Vascular Compromise ◽  
History Of ◽  
Eagle Syndrome ◽  
The Right ◽  
Neck Manipulation

Eagle syndrome is a rare cause of stroke and results as a complication of the elongated styloid process (ESP), which can cause carotid dissection and consequent ischemic stroke. We report a case of a 42-year-old woman with a past medical history of rheumatoid arthritis who developed left hemispheric ischemic stroke after deep tissue massage. Imaging studies revealed an intimal tear of the left carotid artery bulb and bilaterally ESPs, measuring approximately 6 cm on the right and 4.5 cm on the left. It seems that direct vascular compromise by the anomalous styloid process was the cause of her carotid artery dissection and stroke. Moreover, neck manipulation may have been a contributing factor.

scholarly journals Traumatic Bilateral Common Carotid Artery Dissection Due to Strangulation

2006 ◽  
Vol 12 (2) ◽  
pp. 149-154 ◽  
Author(s):  
I. Chokyu ◽  
T. Tsumoto ◽  
T. Miyamoto ◽  
H. Yamaga ◽  
T. Terada ◽  
...  
Keyword(s):  
Spinal Cord ◽  
Carotid Artery ◽  
Common Carotid Artery ◽  
Carotid Artery Dissection ◽  
Artery Dissection ◽  
Bilateral Common Carotid Artery ◽  
Bilateral Carotid ◽  
Cord Injury ◽  
The Right ◽  
Bilateral Carotid Artery

We report a case of bilateral common carotid artery dissection due to strangulation successfully treated by stent placement, with a review of the literature. A 61-year-old woman was strangled by an apron strap. She was admitted to our hospital with tetraparesis, because of spinal cord injury. On the next day, her left hemiparesis aggravated and left facial palsy newly appeared. Diffusion weighted magnetic resonance imaging (MRI) showed new ischemic lesions in the right cerebral hemisphere. Aortography revealed bilateral common carotid artery dissection. Moreover, thrombus or intimal flap was recognized in the right common carotid artery. The right common carotid dissection was fixed with deployment of self expanding stents to prevent the aggravation of ischemic stroke at that time. The contralateral lesion was also treated ten days later because small ischemic lesions were newly recognized in the left hemisphere on MRI. No new neurological deficit appeared after bilateral carotid artery stenting. Her paraparesis completely improved two months after the spinal cord injury. Carotid artery stenting using self expanding stents was especially effective as the treatment for bilateral carotid artery dissection.

Carotid Dissection

2015 ◽  
Author(s):  
Efthymios D. Avgerinos ◽  
Peter Schneider ◽  
Rabih A. Chaer
Keyword(s):  
Carotid Artery ◽  
Internal Carotid Artery ◽  
Endovascular Procedures ◽  
Internal Carotid ◽  
Carotid Artery Dissection ◽  
Artery Dissection ◽  
Carotid Dissection ◽  
Artery Wall ◽  
Ultrasound Findings ◽  
History Of

Carotid artery dissection refers to an intimal tear and eventually hematoma of the carotid artery wall. Although medical therapy is the mainstay of treatment, surgical or endovascular procedures may be indicated to address fluctuating neurologic deficit or expanding pseudoaneurysm. This review surveys the pathophysiology and natural history of carotid dissection and summarizes the results of recent trials and evolving therapeutic options. A table highlights factors predisposing to or potentially associated with carotid dissection. Figures include an illustration of the pathophysiology of internal carotid artery dissection (ICAD); angiograms revealing right internal carotid artery tapering stenosis to occlusion, right internal carotid artery carotid dissection, and distal left ICAD; ultrasound findings of ICAD; and an algorithm for the diagnosis and management of carotid dissection. This review contains 6 figures, 1 table, and 83 references.

scholarly journals Horner's syndrome after blunt cervical and chest trauma: case report

2007 ◽  
Vol 65 (4a) ◽  
pp. 1037-1039 ◽  
Author(s):  
Wellingson Silva Paiva ◽  
Robson Luis Oliveira De Amorim ◽  
Wagner Malago Tavares ◽  
Eduardo Joaquim Lopes Alho ◽  
Brasil Ping Jeng ◽  
...  
Keyword(s):  
Carotid Artery ◽  
Carotid Artery Dissection ◽  
Horner’S Syndrome ◽  
Artery Dissection ◽  
Trauma Patients ◽  
Horner's Syndrome ◽  
Correct Treatment ◽  
Left Apex ◽  
Trauma Case ◽  
The Right

Horner‘s syndrome is the triad of miosis, ptosis, and anhidrosis, resulting from disruption of the sympathetic pathways. This article describes an uncommon case of Horner‘s syndrome in a 22-year-old man after blunt trauma to the neck and chest without carotid artery dissection. The patient was brought to the emergency service after motorcycle fall. Neurologic examination revealed a patient presenting the score 15 at Glasgow Coma Scale. The left eyelid was 1-2 mm lower than the right. Carotid Doppler and angiotomography were undertaken and revealed no abnormalities of the carotid artery. CT disclosed a mediastinal hematoma extending to the left apex, compressing the left sympathetic chain. The understanding of this clinical entity may help the surgeon to make a better differential diagnosis in trauma patients in whom prompt diagnosis is critical to stablish the correct treatment.

Emergent Endovascular Treatment of a Spontaneous Internal Carotid Artery Dissection with Pseudoaneurysm

2003 ◽  
Vol 10 (3) ◽  
pp. 643-646 ◽  
Author(s):  
Albert Tseng ◽  
Venkatesh Ramaiah ◽  
Julio A. Rodriguez-Lopez ◽  
Paul E. Perkowshi ◽  
Peter B. Del Santo ◽  
...  
Keyword(s):  
Carotid Artery ◽  
Internal Carotid Artery ◽  
Endovascular Treatment ◽  
Internal Carotid ◽  
Common Femoral Artery ◽  
Carotid Artery Dissection ◽  
Coronary Stent ◽  
Artery Dissection ◽  
Pseudoaneurysm Formation ◽  
The Right

Purpose: To report the use of a coronary stent-graft for the endovascular treatment of a spontaneous internal carotid artery (ICA) dissection complicated by a large pseudoaneurysm. Case Report: A 68-year-old man presented to an outside hospital with complaints of headache, severe left-sided neck pain, fever, chills, and vomiting. Contrast-enhanced computed tomography revealed a large (3.5×3 cm) extracranial aneurysm of the left ICA. The patient was emergently transferred to our facility for endovascular treatment of the carotid aneurysm. Via a percutaneous access in the right common femoral artery, 2 Jostent coronary stent-grafts were deployed across the aneurysm with no evidence of a residual pseudoaneurysm. The patient was hemodynamically stable throughout the procedure. Duplex examination at 9 months revealed no evidence of a residual pseudoaneurysm, dissection, or endoleak. Conclusions: Covered coronary stents may have a role in the treatment of spontaneous ICA dissection with pseudoaneurysm formation.

Head Pain in Non-Traumatic Carotid Artery Dissection: A Series of 65 Patients

Cephalalgia ◽  
1994 ◽  
Vol 14 (1) ◽  
pp. 33-36 ◽  
Author(s):  
V Biousse ◽  
J D'Anglejan-Chatillon ◽  
H Massiou ◽  
M-G Bousser
Keyword(s):  
Carotid Artery ◽  
Internal Carotid ◽  
Clinical Presentation ◽  
Past History ◽  
Carotid Artery Dissection ◽  
Artery Dissection ◽  
History Of ◽  
Cephalic Pain ◽  
Extracranial Ica ◽  
Angiographic Findings

In order to assess the prevalence and characteristics of cephalic pain in internal carotid artery (ICA) dissection, and to compare clinical and angiographic features of patients with painful and non-painful dissections, we observed 65 patients with angiographically diagnosed extracranial ICA dissection from 1972 to 1990. Forty-eight patients (74%) complained of a cephalic pain which was inaugural in 38 (58.5%). It was homolateral to the dissection in 79% of cases and lasted from 1 h to 30 days, with a median of 5 days. Signs of cerebral or retinal ischemia were observed in 79% of patients, often delayed and occurring up to 29 days after the onset of pain. A painful Horner's syndrome was present in 31% of patients, and was the only manifestation of dissection in 16%. The clinical presentation of the dissections and angiographic findings were similar in patients with and without pain except for a past history of migraine which was more frequent in patients with painful dissections. Cephalic pain is frequent and often inaugural in carotid dissection. Its recognition is important for early diagnosis and treatment.

scholarly journals Paroxysmal hemicrania associated to carotid artery dissection: a case report

2021 ◽  
pp. 144-147
Author(s):  
Felipe Araújo Andrade Oliveira ◽  
Pedro Augusto Sampaio Rocha-Filho
Keyword(s):  
Carotid Artery ◽  
Internal Carotid ◽  
Case Reports ◽  
Nasal Congestion ◽  
Carotid Artery Dissection ◽  
Paroxysmal Hemicrania ◽  
Artery Dissection ◽  
Left Internal Carotid Artery ◽  
Left Carotid Artery ◽  
The Right

There are numerous case reports relating trigeminal autonomic cephalalgias to structural injuries. However there is no description of the association between paroxysmal hemicrania and carotid artery dissection.  We describe a previously healthy 63-year-old male presented with the onset of severe, throbbing pain in the right frontal region, lasting between 10 and 30 minutes, with a frequency of approximately two to three attacks per day, which began two days before seeking medical care. Pain was associated with ipsilateral tearing, semiptosis and nasal congestion. A cervical arterial magnetic resonance angiography demonstrated left carotid artery dissection in the C1/C2 segment of the left internal carotid artery. The patient became asymptomatic after indomethacin use. We conclude that the possibility of investigating carotid dissection should be considered in patients with paroxysmal hemicrania.  

scholarly journals Internal Carotid Artery Dissection during Puerperium: A Case Report

2021 ◽  
Author(s):  
Leonardo de Sousa Bernardes ◽  
Raphael Palomo Barreira ◽  
Marina Trombin Marques ◽  
Danyelle Sadala Reges ◽  
Vivian Dias Baptista Gagliardi ◽  
...  
Keyword(s):  
Case Report ◽  
Carotid Artery ◽  
Internal Carotid Artery ◽  
Neck Pain ◽  
Cerebral Artery ◽  
Internal Carotid ◽  
Carotid Artery Dissection ◽  
Artery Dissection ◽  
Internal Carotid Artery Dissection ◽  
The Right

Background: Carotid or vertebral artery dissection is a rare puerperium event, occurring in less than 6% of cases. Although physiopathology is not completely understood, it is probably multifactorial involving increased cardiac output, hypervolemia and hormonal changes remodeling endothelium and favoring dissection. Most patients present headache and neck pain, but it is also reported Horner syndrome, tinnitus, retroorbital pain and cranial nerve palsies. Case Report: Female, 39-year-old patient in the 20th day of puerperium presents a sudden headache with transitory left hemiparesis and dysarthria for 30 minutes. Magnetic Resonance Imaging (MRI) with angioresonance revealed an area of right middle cerebral artery (MCA) infarction and right internal carotid artery dissection in the cervical segment with a large intraluminal thrombus. The diagnosis was stablished as ischemic stroke caused by carotid dissection. Transcranial doppler presented post stenotic flow in the right MCA, flow inversion in the right anterior cerebral artery (ACA) and ipsilateral collateral circulation of the external carotid artery. After two months on double antiplatelet treatment (apirin 100mg and clopidogrel 75mg), it was partially recanalized and there was improvement in the collateral and hemodynamic pattern. Conclusion: Puerperium pacients describing intense headache or neck pain should be investigated with MRI and angioresonance of intracranial and cervical vessels. In the cervical arterial dissection it is recommended double antiplatelet therapy, for three to six months.

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