Spontaneous carotid artery dissection in pregnancy

2016 ◽  
Vol 5 (2) ◽  
pp. 113-115
Author(s):  
Jessica Rüegger ◽  
Franziska Krähenmann ◽  
Urs Schwarz ◽  
Spyridon Kollias ◽  
Roland Zimmermann ◽  
...  
Keyword(s):  
Magnetic Resonance ◽  
Carotid Artery ◽  
Internal Carotid Artery ◽  
Neck Pain ◽  
Mr Angiography ◽  
Internal Carotid ◽  
Carotid Artery Dissection ◽  
Artery Dissection ◽  
The Right ◽  
In Pregnancy

Abstract We report on a 35-year-old woman who presented at 36 weeks of gestation with headaches and arterial hypertension. She was discharged after ruling out pre-eclampsia. The next day she returned with worsening headaches and an onset of Horner’s syndrome. A magnetic resonance (MR) angiography showed extensive dissection of the right-sided internal carotid artery. Anticoagulation and antihypertensive therapies were initiated after delivery of the baby by caesarean. The patient recovered fully. Headache in pregnancy is not always due to pre-eclampsia. Carotid artery dissection (CAD) is a rare but severe cause of headache that typically presents with neck pain and focal neurologic symptoms. Once the diagnosis is established, an immediate treatment should be started in order to minimise damage, especially ischaemic lesions.

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.

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.

Central retinal artrey occlusion associated with head or neck pain revealing spontaneous internal carotid artery dissection

2000 ◽  
Vol 129 (1) ◽  
pp. 108-109 ◽  
Author(s):  
Fayçal Mokhtari ◽  
Pascale Massin ◽  
Michel Paques ◽  
Valéqrie Biousse ◽  
Emmanuel Houdart ◽  
...  
Keyword(s):  
Carotid Artery ◽  
Internal Carotid Artery ◽  
Neck Pain ◽  
Internal Carotid ◽  
Carotid Artery Dissection ◽  
Artery Dissection ◽  
Internal Carotid Artery Dissection

scholarly journals A case series of 22 patients with internal carotid artery dissection

2011 ◽  
Vol 64 (11-12) ◽  
pp. 575-578 ◽  
Author(s):  
Ivana Divjak ◽  
Petar Slankamenac ◽  
Mirjana Jovicevic ◽  
Tamara Rabi-Zikic ◽  
Aleksandra Lucic-Prokin ◽  
...  
Keyword(s):  
Magnetic Resonance Imaging ◽  
Magnetic Resonance ◽  
Carotid Artery ◽  
Internal Carotid Artery ◽  
Internal Carotid ◽  
Carotid Artery Dissection ◽  
Artery Dissection ◽  
Internal Carotid Artery Dissection ◽  
Resonance Imaging ◽  
Sensorimotor Deficit

The aim of this study was to analyze the spectrum of clinical presentations of internal carotid artery dissection. Twenty-two patients with internal carotid artery dissection, mean age 39.02, were evaluated over the past ten years. Magnetic resonance imaging and magnetic resonance angiography were used to establish the diagnosis. Facial and neck pain and Horner?s syndrome were the only presenting symptoms in 4 patients (without brain infarction); facial pain, Horner?s syndrome and contralateral sensorimotor deficit in 6; headache and contralateral sensorimotor deficit in 2; contralateral sensorimotor deficit with or without speech impairment in 10. Internal carotid artery dissection was triggered by a trauma in 7, whereas it was spontaneous in 15. Magnetic resonance imaging revealed infarction in 18 patients. A good outcome (modified Rankin score 0-2) was seen in 20 patients. The spectrum of clinical presentations of internal carotid artery dissection is variable. Internal carotid artery dissection is not necessarily accompanied by infarction on magnetic resonance imaging.

Jugular Foramen Syndrome with Miosis: A Sign of Internal Carotid Artery Dissection

1998 ◽  
Vol 11 (1) ◽  
pp. 99-102
Author(s):  
F.A. Lupo ◽  
S.C. Perfetto ◽  
G. Sticchi
Keyword(s):  
Magnetic Resonance ◽  
Carotid Artery ◽  
Internal Carotid Artery ◽  
Internal Carotid ◽  
Spontaneous Remission ◽  
Jugular Foramen ◽  
Carotid Artery Dissection ◽  
Clinical Aspects ◽  
Artery Dissection ◽  
Internal Carotid Artery Dissection

We describe a case of left extra and intracranial internal carotid artery dissection in a 59-year-old man who presented with the clinical features of left jugular foramen syndrome (dysphonia, dysphagia, ageusia, paralysis of the sternocleidomastoid muscle) and ipsilateral miosis with acute onset, worsening in the first 24 hours and spontaneous remission over the next thirty days. The patient was investigated by computed tomography magnetic resonance and digital angiography and received conservative treatment. The clinical aspects are discussed, emphasizing the major role of magnetic resonance in the diagnosis of the syndrome.

scholarly journals Internal carotid artery dissection in a patient with recent respiratory infection: case report of a possible link

2005 ◽  
Vol 63 (2b) ◽  
pp. 523-526 ◽  
Author(s):  
Cynthia Resende Campos ◽  
Thiago Gasperini Bassi ◽  
Fabiano Pinto ◽  
Demétrius Kasak P. Abrahão
Keyword(s):  
Carotid Artery ◽  
Internal Carotid Artery ◽  
Respiratory Infection ◽  
Internal Carotid ◽  
Causal Link ◽  
Carotid Artery Dissection ◽  
Artery Dissection ◽  
Cervical Artery Dissection ◽  
Internal Carotid Artery Dissection ◽  
The Right

The pathogenesis of spontaneous cervical artery dissection remains unknown. Infection-mediated damage of the arterial wall may be an important triggering mechanism. We describe a 21 year-old man with respiratory infection (bronchial pneumonia) which was diagnosed and treated with antibiotic few days prior to the right internal carotid artery dissection. The patient presented ischemic retinal and cerebral strokes. Based on literature review, we discuss the possibility of a causal link between infection and arterial dissection.

scholarly journals Compliant balloon angioplasty for the treatment of internal carotid artery dissection

2018 ◽  
Vol 25 (1) ◽  
pp. 47-50
Author(s):  
Nicolas Bricout ◽  
Nasreddine Nouri ◽  
Hilde Henon ◽  
Laurent Estrade ◽  
Fakhreddine Boustia ◽  
...  
Keyword(s):  
Magnetic Resonance ◽  
Carotid Artery ◽  
Internal Carotid Artery ◽  
Balloon Angioplasty ◽  
Internal Carotid ◽  
Brain Magnetic Resonance Imaging ◽  
Intravenous Thrombolysis ◽  
Carotid Artery Dissection ◽  
Artery Dissection ◽  
Internal Carotid Artery Dissection

This report describes the innovative management of a severe haemodynamic stroke related to an occlusive extracranial internal carotid artery dissection. Intravenous thrombolysis combined with endovascular treatment were undertaken on the basis of a total mismatch profile (National Institutes of Health stroke scale (NIHSS) score of 27 and infarct volume on diffusion-weighted imaging of 0 mL). Balloon angioplasty using a long and compliant balloon microcatheter allowed complete recovery of the intracranial blood flow. The patient showed dramatic clinical improvement (day 1, NIHSS 5) and favourable functional outcome (day 90, modified Rankin scale score 2). Day 90 follow-up brain magnetic resonance imaging revealed no ischaemic change and magnetic resonance angiography assessed the patency of the internal carotid artery.

scholarly journals Internal Carotid Artery Dissection Presenting as Partial Horner’s Syndrome and Vertigo

2020 ◽  
Vol 185 (9-10) ◽  
pp. e1840-e1842
Author(s):  
Jeffrey C Teixeira ◽  
Paula J Jackson
Keyword(s):  
Carotid Artery ◽  
Internal Carotid Artery ◽  
Internal Carotid ◽  
Intramural Hematoma ◽  
Carotid Artery Dissection ◽  
Physical Exam ◽  
Artery Dissection ◽  
Unilateral Headache ◽  
Romberg Test ◽  
The Right

Abstract Distinguishing between central and peripheral causes of vertigo can be challenging not only in an acute setting but also in chronic settings. A thorough review of systems and physical exam can assist providers in differentiating central versus peripheral etiologies and the need for urgent imaging. In this case, a 47-year-old man presented with vertigo, right-sided hearing loss, right-sided headache, and right-sided facial pain that began 4 weeks before while the patient was on a cruise ship. His physical exam findings were notable for anisocoria with right pupil 3.5 and left pupil 4.5, mild ptosis on the right side, positive Romberg test to the right, and Fakuda test with deviation to the right. Urgent magnetic resonance imaging revealed dissection of the right cervical internal carotid artery with a nonocclusive intramural hematoma. This case illustrates the importance of imaging in vertigo patients in which a central etiology is suspected. It further demonstrates that isolated partial Horner’s or unilateral headache may indeed be the only presenting sign in a carotid dissection.

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