scholarly journals Ischaemic stroke caused by spontaneous unilateral carotid artery dissection in patient with connective tissue disorder

2021 ◽  
Vol 21 (1) ◽  
pp. 41-46
Author(s):  
Weronika Pużyńska ◽  
◽  
Anna Mirończuk ◽  
Katarzyna Kapica-Topczewska ◽  
Adam Łukasiewicz ◽  
...  
Keyword(s):  
Carotid Artery ◽  
Connective Tissue ◽  
Ischaemic Stroke ◽  
Young Patients ◽  
Carotid Artery Dissection ◽  
Artery Dissection ◽  
Left Internal Carotid Artery ◽  
Cervical Artery Dissection ◽  
Connective Tissue Disorders ◽  
Ehlers Danlos Syndrome

Background: Spontaneous cervical artery dissection is a major cause of ischaemic stroke in young patients. It is supposed that genetic variants associated with connective tissue disorders often lead to neurovascular complications, the management of which remains a challenge. Case presentation: A 30-year-old female was admitted to the Department of Neurology with an episode of visual disturbances, speech problems, and concomitant headache. Computed tomography angiography revealed left internal carotid artery dissection. Magnetic resonance of the brain showed cortical and subcortical acute ischaemic lesions in the left cerebral hemisphere. The patient was diagnosed with vascular Ehlers–Danlos syndrome based on the clinical course of the disease. Conservative treatment was administered with full neurological recovery. Conclusion: It is very important for clinicians to consider the coexistence of genetically determined connective tissue disorders in young patients who develop arterial dissections.

scholarly journals Unusual Posttraumatic Vascular and Cerebral Injuries in Young Patients

2018 ◽  
Vol 32 (2) ◽  
pp. 224-229
Author(s):  
Emilia Marciuc ◽  
M. Barcan ◽  
B. Dobrovăţ ◽  
Roxana Popescu ◽  
Cornelia Tudorache ◽  
...  
Keyword(s):  
Carotid Artery ◽  
Motor Vehicle ◽  
Young Patients ◽  
Carotid Artery Dissection ◽  
Neurological Deficits ◽  
Cervical Region ◽  
Artery Dissection ◽  
Left Internal Carotid Artery ◽  
Vehicle Collision ◽  
Additional Imaging

Abstract Blunt carotid artery injury is a relatively rare but potentially lethal injury that predominantly occurs in high-impact mechanisms such as motor-vehicle collision. Any simptoms or neurological deficits following a multiple trauma patient mandates a thorough evaluation and consideration of BCI. This is a case report on two young patients with neurologic simptoms developed after blunt trauma in the cervical region. Both patients had left internal carotid artery dissection diagnosed on a CT-angiography, followed by middle cerebral artery territory infarction. Although it can be a delayed onset with no signs of vascular demage, we believe that, by implementing a protocol with additional imaging for early detection, we can prevent a devastating outcome.

Young Stroke Secondary To Fibromuscular Dysplasia Causing Carotid Artery Dissection

2021 ◽  
Author(s):  
Rumesh Ranasinghe ◽  
Shifa Azher ◽  
Udaya Ralapanawa ◽  
Parackrama Karunathilake
Keyword(s):  
Carotid Artery ◽  
Internal Carotid Artery ◽  
Fibromuscular Dysplasia ◽  
Internal Carotid ◽  
Young Patients ◽  
Hemorrhagic Transformation ◽  
Carotid Artery Dissection ◽  
Artery Dissection ◽  
Left Internal Carotid Artery ◽  
Childbearing Age

Abstract Background: Fibromuscular dysplasia (FMD) is a rare, medium-sized arteriopathy affecting less than 7% of the population. It affects predominantly young women of childbearing age. Stroke caused by fibromuscular dysplasia of the carotid artery is uncommon and reported to range between 0.6% by angiography and 1.1% by autopsy. Case Presentation: A 35-year-old mother of two children, previously well, was admitted to our hospital with right-sided spastic hemiparesis with upper motor neuron type facial nerve palsy. Non-contrast CT (NCCT) brain on admission revealed left-sided middle cerebral arterial territory infarction with possible hemorrhagic transformation with midline shift. She had progressive neurological features where NCCT brain in 24 hours showed an increase in the size of the hemorrhage. Magnetic resonance imaging (MRI) of the brain, including angiogram of neck vessels, revealed acute dissection of the left internal carotid artery with acute thrombosis, left frontoparietal hemorrhagic infarction, and the constellation of MRI showed features suggestive of left cervico-cranial fibromuscular dysplasia complicated by acute internal carotid artery dissection. She was started on low-dose aspirin, and 40 mg of atorvastatin and anticoagulants were not started because of the bleeding risk as she had a hemorrhagic transformation infarction. She was discharged and referred for inward physiotherapy and planned to repeat the MRI brain with the neck vessel angiogram in three weeks and arranged digital subtraction angiography in three months. Unfortunately, she was lost for follow-up.Conclusion: Detailed evaluation of the young patients with ischaemic stroke is helpful to diagnose rare diseases such as FMD involving carotid arteries leading to a better treatment choice between anticoagulation vs. antiplatelet therapy.

Spontaneous carotid—jugular fistula and carotid dissection in a patient with multiple intracranial arachnoid cysts and hemifacial atrophy: a generalized connective tissue disorder?

1995 ◽  
Vol 83 (3) ◽  
pp. 546-549 ◽  
Author(s):  
Wouter I. Schievink ◽  
David G. Piepgras ◽  
Douglas A. Nichols
Keyword(s):  
Carotid Artery ◽  
Connective Tissue ◽  
Internal Carotid ◽  
Jugular Vein ◽  
Connective Tissue Disorder ◽  
Carotid Artery Dissection ◽  
Arachnoid Cysts ◽  
Artery Dissection ◽  
Hemifacial Atrophy ◽  
Content Type

✓ The authors report a case of a 45-year-old woman with pulsatile tinnitus who was found to have an unusual spontaneous fistula between the petrous internal carotid artery and internal jugular vein. The fistula resolved spontaneously, possibly related to daily manual compression of the ipsilateral common carotid artery. The patient also had a contralateral carotid artery dissection, multiple intracranial arachnoid cysts, and hemifacial atrophy. Her medical history was significant for easy bruisibility, abnormal scarring, and mitral valve prolapse. This association appears unique and may represent a previously undescribed generalized connective tissue disorder.

scholarly journals Internal carotid artery dissection in a patient with Ehlers-Danlos syndrome type IV: diagnosis and management

2013 ◽  
Vol 12 (2) ◽  
pp. 174-179 ◽  
Author(s):  
Michel Nasser ◽  
Murilo Bucci Vega ◽  
Luca Giovani Antonio Pivetta ◽  
Ana Izabel Nasser ◽  
Debora Gusmao Melo
Keyword(s):  
Carotid Artery ◽  
Internal Carotid Artery ◽  
Internal Carotid ◽  
Vascular Complications ◽  
Carotid Artery Dissection ◽  
Artery Dissection ◽  
Internal Carotid Artery Dissection ◽  
Ehlers Danlos Syndrome ◽  
Type Iv ◽  
Danlos Syndrome

Ehlers-Danlos syndrome (EDS) type IV, also known as vascular EDS, is an inherited connective tissue disorder with an estimated prevalence of 1/100,000 to 1/250,000. In EDS type IV, vascular complications may affect all anatomical areas, with a preference for large- and medium-sized arteries. Dissections of the vertebral and carotid arteries in their extra- and intra-cranial segments are typical. The authors report the case of a patient with EDS type IV for whom the diagnosis was established based on clinical signs and who developed internal carotid artery dissection at the age of 44 years. In the absence of a specific treatment for EDS type IV, medical interventions should focus on symptomatic relief, prophylactic measures, and genetic counseling. Invasive imaging techniques are contraindicated, and a conservative approach to vascular complications is usually recommended.

scholarly journals Intentional subintimal carotid stenting of internal carotid dissection in a patient with acute ischaemic stroke

2016 ◽  
Vol 23 (1) ◽  
pp. 69-72 ◽  
Author(s):  
Nicola Limbucci ◽  
Sergio Nappini ◽  
Andrea Rosi ◽  
Leonardo Renieri ◽  
Arturo Consoli ◽  
...  
Keyword(s):  
Carotid Artery ◽  
Ischaemic Stroke ◽  
Acute Ischaemic Stroke ◽  
Internal Carotid ◽  
Carotid Stenting ◽  
Carotid Artery Dissection ◽  
Artery Dissection ◽  
Carotid Dissection ◽  
Clinical Recovery ◽  
Intracranial Embolism

Carotid artery dissection is a common cause of juvenile stroke. Endovascular treatment of acute stroke due to carotid dissection can be challenging, and endoluminal crossing of the dissection is sometimes impossible. We describe a case of intentional subintimal recanalisation of a cervical carotid dissection followed by intracranial thrombectomy and stenting. We report the case of a young woman with severe acute ischaemic stroke due to carotid artery dissection and intracranial embolism. After failure of endoluminal crossing of the dissected segment, intentional subintimal crossing with re-entry distally to the dissection was achieved and a stent was deployed. Then, middle cerebral artery thrombectomy was performed achieving good recanalisation. Acute thrombus formed in the bulged segment of the carotid stent and was managed with additional stent placement. The patient had a good clinical recovery. In selected cases, after failure of conventional techniques, subintimal recanalisation of carotid dissections may be performed.

scholarly journals Running, ischaemic stroke and carotid artery dissection

QJM ◽  
2015 ◽  
Vol 108 (12) ◽  
pp. 973-974 ◽  
Author(s):  
N.R. Evans ◽  
V. Harper ◽  
D.J. Scoffings ◽  
E.A. Warburton
Keyword(s):  
Carotid Artery ◽  
Ischaemic Stroke ◽  
Carotid Artery Dissection ◽  
Artery Dissection
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