Carotid Artery Dissection

Year 2020, , 3 - 6, 10.09.2020

Şükrü Gürbüz

https://doi.org/10.33706/jemcr.514089

Abstract

Carotid
artery dissection, firstly described by Pratt-Thomas and Berger in 1947,
typically begins in inner layer of artery wall, proceeds to the middle layer,
and intramurally extends along length of the artery as a result of the pressure
produced by blood stream. This study aims to report a case in which internal
carotid artery dissection was diagnosed as secondary to trauma. A 24-year-old
male patient was brought to the emergency room by 112 emergency service team
after a motorcycle accident. Physical examination of the patient revealed a painful
dermabrasion in his right neck region and other system examinations were normal.
Carotid-vertebral color Doppler ultrasonography was performed on the patient because
he had a right neck pain. Accordingly, an intimal flap appearance compatible
with dissection was observed on the right internal carotid artery (ICA) proximal
segment. Then, brain+cervical CT angiography was performed on the patient, and an
appearance compatible with dissection was observed in the right ICA. Therefore,
the patient was referred to neurology and neurosurgery consultation and accordingly
admitted to neurosurgery intensive care unit. As a result, carotid artery
dissection in addition to other intracranial pathologies should be considered among
differential diagnoses for patients with head and/or neck pain complaints
regardless of whether or not they have a trauma history.

Keywords

Carotid artery, trauma, A Case Report

References

• 1. Pratt-Thomas HR, Berger KE. Cerebellar and spinal injuries after chiropractic manipulation. JAMA. 1947;133:600–603.
• 2. Şengül G, Kadıoğlu HH, Aydın IH. Arteriyel diseksiyon sendromları. Turkiye Klinikleri J Surg Med Sci. 2006; 2: 163-5.
• 3. Schievink WI, Mokri B, Whisnant JP. Internal carotid artery dissection in a community Rochester, Minnesota, 1987-1992. Stroke 1993;24: 1678–80.
• 4. Schievink WI. Spontaneous dissection of the carotid and vertebral arteries. N Engl J Med 2001;344:898–906.
• 5. Arnold M, Bousser MG. Carotid and vertebral artery dissection. Pract Neurol 2005;5:100–9.
• 6. Srinivasan J, Newell DW, Sturzenegger M, Mayberg MR, Winn HR. Transcranial Doppler in the evaluation of internal carotid artery dissection. Stroke 1996 ;27(7):1226-30.
• 7. Desfontaines P, Despland PA. Dissection of the internal carotid artery: aetiology, symptomatology, clinical and neurosonological followup, and treatment in 60 consecutive cases. Acta Neurol Belg 1995;95(4):226-34.
• 8. Biousse V, D'Anglejan-Chatillon J, Touboul PJ, Amarenco P, Bousser MG. Time course of symptoms in extracranial carotid artery dissections. A series of 80 patients. Stroke 1995;26(2):235-9.