Spontaneous carotid dissection

Flumignan, Carolina Dutra Queiroz; Flumignan, Ronald Luiz Gomes; Nakano, Luís Carlos Uta; Amorim, Jorge Eduardo de

doi:10.1590/1806-9282.63.05.397

Cited by 6 publications

(4 citation statements)

References 12 publications

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“…The leading cause is a tear in the intimal layer of the artery, followed by blood accumulation under arterial pressure. The result is either stenosis/occlusion of the arterial lumen or thrombosis at the dissection site, which can cause downstream emboli [ 19 , 20 ]. In our patient, the distal V2 segment of the vertebral artery was dissected.…”

Section: Discussionmentioning

confidence: 99%

Postpartum Acute Basilar Artery Occlusion Secondary to Vertebral Artery Dissection. Case Report and Literature Review

Drăghici

Mărginean

Filep

et al. 2021

The Journal of Critical Care Medicine

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Female patients in the peripartum and postpartum periods have an increased risk of stroke than nonpregnant women. Cerebrovascular complications of pregnancy represent a significant cause of maternal mortality and morbidity and are potentially disabling. Acute basilar artery occlusion secondary to spontaneous vertebral artery dissection in the postpartum period is an infrequent entity and a major diagnostic and treatment challenge. In the present case, a 37-year-old female patient, eight weeks after caesarean delivery, presented with a history of sudden cervical pain, followed by headache and dizziness. Some hours later, she was found unconscious by her family and was transferred to the emergency department, where a neurological status assessment suggested vertebrobasilar stroke. The imagistic workup revealed right vertebral artery dissection and basilar artery occlusion without constituted ischemic lesions. The patient underwent endovascular intervention with dilation of the narrowed vertebral artery and stent retriever basilar artery thrombectomy, with a favourable clinical outcome. This report first presents the details of this case and the relevant literature data on postpartum arterial dissections and the subsequent ischemic complications and available treatment options.

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Section: Discussionmentioning

confidence: 99%

Postpartum Acute Basilar Artery Occlusion Secondary to Vertebral Artery Dissection. Case Report and Literature Review

Drăghici

Mărginean

Filep

et al. 2021

The Journal of Critical Care Medicine

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“…Cerebrovascular accident (CVA) is the second most common vascular disease after acute myocardial infarction, and internal carotid artery (ICA) stenosis is associated with approximately 15% of all ischemic strokes 1 - 6 . Stroke is an important cause of hospitalization, morbidity, and death.…”

Section: Introductionmentioning

confidence: 99%

“…In this scenario, DUS has become the first choice for screening for ICA stenosis, since it is widely available, has a lower cost than the reference tests mentioned, is non-invasive, and has sufficient accuracy. The DUS technique involves the use of several ultrasound resources to determine the degree of stenosis, including B-mode morphology, color Doppler, and pulsed wave Doppler, and may also include the use of microbubble contrast 6 , 7 , 11 , 14 . CTA has the disadvantage of using ionizing radiation and requiring, in all cases, the administration of iodinated contrast, known to be nephrotoxic 9 .…”

Section: Introductionmentioning

confidence: 99%

Accuracy of duplex ultrasonography versus angiotomography for the diagnosis of extracranial internal carotid stenosis

DAOLIO,

ZANIN,

FLUMIGNAN

et al. 2024

Rev. Col. Bras. Cir.

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Introduction: Internal carotid artery (ICA) stenosis causes about 15% of ischemic strokes. Duplex ultrasonography (DUS) is the first line of investigation of ICA stenosis, but its accuracy varies in the literature and it is usual to complement the study with another more accurate exam when faced with significant stenosis. There is a lack of studies that compare DUS with angiotomography (CTA) in the present literature. Methods: we performed an accuracy study, which compared DUS to CTA of patients in a tertiary hospital with a maximum interval of three months between tests. Patients were selected retrospectively, and two independent and certified vascular surgeons evaluated each image in a masked manner. When there was discordance, a third evaluator was summoned. We evaluated the diagnostic accuracy of ICA stenosis of 50-94% and 70-94%. Results: we included 45 patients and 84 arteries after inclusion and exclusion criteria applied. For the 50-94% stenosis range, DUS accuracy was 69%, sensitivity 89%, and specificity 63%. For the 70-94% stenosis range, DUS accuracy was 84%, sensitivity 61%, and specificity 93%. There was discordance between CTA evaluators with a change from clinical to surgical management in at least 37.5% of the conflicting reports. Conclusion: DUS had an accuracy of 69% for stenoses of 50-94% and 84% for stenoses of 70-94% of the ICA. The CTA analysis depended directly on the evaluator with a change in clinical conduct in more than 37% of cases.

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“…Korábban a hagyományos digitális szubtrakciós angiográfia (DSA) volt a dissectiodiagnosztika "gold standarja". A DSA korlátai, illetve lehetséges iatrogén szövődményei miatt azonban háttérbe szorult a noninvazív képalkotó eljárások (carotis-vertebralis duplex szonográfia, CT és CT-angiográfia, MR és MR-angiográfia) fejlődésének köszönhetően [4,9].…”

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A nyaki ütőerek dissectiója – 19 eset retrospektív elemzése

et al. 2019

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Cervical artery dissection is a common cause of stroke in young adults. It might occur shortly after a forceful neck trauma or a minor injury. However, spontaneous dissection is also common, which is associated with genetic, anatomical or environmental risk factors. Cervical artery dissection can produce a broad spectrum of clinical presentation varying from local symptoms to focal neurological deficits determined by the arterial territory involved. Early recognition is important since immediate initiation of treatment can significantly improve patient outcomes. While clinical features may raise suspicion for dissection, the diagnosis has to be confirmed by neuroimaging findings. The purpose of this paper is to give an overview on cervical (carotid and vertebral) artery dissections while presenting 19 cases. During three years, we evaluated the clinical features, risk factors, diagnostic and therapeutic procedures of these patients admitted with extracranial artery dissection. The prognosis of the disease can vary, 42% of our patients became asymptomatic. Orv Hetil. 2019; 160(22): 861–868.

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Spontaneous carotid dissection

Cited by 6 publications

References 12 publications

Postpartum Acute Basilar Artery Occlusion Secondary to Vertebral Artery Dissection. Case Report and Literature Review

Postpartum Acute Basilar Artery Occlusion Secondary to Vertebral Artery Dissection. Case Report and Literature Review

Accuracy of duplex ultrasonography versus angiotomography for the diagnosis of extracranial internal carotid stenosis

A nyaki ütőerek dissectiója – 19 eset retrospektív elemzése

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