scholarly journals Symptomatic internal carotid artery dissection and kinking in a patient with fibromuscular dysplasia

2021 ◽  
Vol 20 ◽  
Author(s):  
Victor Bilman ◽  
Luca Apruzzi ◽  
Domenico Baccellieri ◽  
Francesca Sanvito ◽  
Luca Bertoglio ◽  
...  
Keyword(s):  
Carotid Artery ◽  
Internal Carotid Artery ◽  
Fibromuscular Dysplasia ◽  
Internal Carotid ◽  
Young Patients ◽  
Duplex Ultrasound ◽  
Carotid Artery Dissection ◽  
Uneventful Recovery ◽  
Artery Dissection ◽  
History Of

Abstract Isolated dissection of the internal carotid artery (ICA) is rare in young patients and is a cause for strong suspicion of fibromuscular dysplasia (FMD), especially when associated with artery elongation and tortuosity. The natural history of cerebrovascular FMD is unknown and management of symptomatic patients can be challenging. We report the case of a 44-year-old female patient with a history of transient ischemic attack in the absence of cardiovascular risk factors, associated with an isolated left ICA dissection and kinking. Carotid duplex ultrasound confirmed the diagnosis of dissection and demonstrated severe stenosis of the left ICA. The patient underwent surgical repair and histopathological evaluation confirmed the diagnosis of FMD with dissection. An autogenous great saphenous vein bypass was performed and the patient had an uneventful recovery. Cervical carotid artery dissection can be related to underlying arterial pathologies such as FMD, and the presence of ICA tortuosity highlights certain peculiarities for optimal management, which might be surgical.

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.

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.

Carotid artery dissection: a case of recurrence

2021 ◽  
Vol 14 (5) ◽  
pp. e241718
Author(s):  
Pratiksha Srinivas ◽  
Joel Nwosu ◽  
Aloaye Foy-Yamah ◽  
Clement Okiemute Ejohwomu
Keyword(s):  
Carotid Artery ◽  
Internal Carotid Artery ◽  
Internal Carotid ◽  
Brain Mri ◽  
Carotid Artery Dissection ◽  
Artery Dissection ◽  
Left Internal Carotid Artery ◽  
Internal Carotid Artery Dissection ◽  
Ct Angiogram ◽  
History Of

A 53-year-old healthy man with history of left internal carotid artery dissection in 2006 presented with right-sided facial pain with paraesthesia associated with taste and speech disturbances. A CT angiogram was done without further delay considering the patient’s history of dissection, and revealed a non-occlusive right-sided internal carotid artery dissection at the skull base level. The neurologist, neurosurgeons and stroke team were involved in the care, and the patient was immediately moved to a tertiary hospital for further intervention. Brain MRI and magnetic resonance angiography did not reveal further progression of the dissection and the patient was therefore medically managed.

scholarly journals The endovascular emergency treatment of an acute carotid artery dissection after Krav Maga training—a case report

2017 ◽  
Vol 25 (2) ◽  
pp. 113-116
Author(s):  
Dariusz Janczak ◽  
Agnieszka Ziomek ◽  
Michal Lesniak ◽  
Maciej Malinowski ◽  
Kornel Pormanczuk ◽  
...  
Keyword(s):  
Carotid Artery ◽  
Internal Carotid Artery ◽  
Internal Carotid ◽  
Young Patients ◽  
Carotid Artery Dissection ◽  
Artery Dissection ◽  
Internal Carotid Artery Dissection ◽  
Penumbral Region ◽  
The Right ◽  
Spontaneous Dissection

Carotid artery dissection accounts for 20%–30% of all ischemic strokes in young patients aged <50 years. Recent guidelines on carotid disease management do not differentiate between traumatic and spontaneous dissection. We present a case of a 36-year-old male patient with the right internal carotid artery dissection treated with two XACT Abbot 6–8 mm × 40 mm stents placement after he was strangled during Krav Maga training. It is the most effective way to prevent the imminent stroke in the penumbral region. The safety and outcome of stent placement in internal carotid artery dissection remains unclear and further randomized trials are needed.

Spontaneous Bilateral Internal Carotid Artery Dissection with Acute Stroke in Young Patients

2006 ◽  
Vol 56 (4) ◽  
pp. 230-234 ◽  
Author(s):  
Hsiu-Chuan Wu ◽  
Yi-Chun Chen ◽  
Chi-Jen Chen ◽  
Sien-Tsong Chen ◽  
Tsong-Hai Lee
Keyword(s):  
Carotid Artery ◽  
Internal Carotid Artery ◽  
Acute Stroke ◽  
Internal Carotid ◽  
Young Patients ◽  
Carotid Artery Dissection ◽  
Artery Dissection ◽  
Internal Carotid Artery Dissection ◽  
Stroke In Young
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