Bilateral Internal Carotid Artery Dissection in the Postpartum Period

Baffour, Francis; Kirchoff-Torres, Kathryn F.; Einstein, Francine; Karakash, Scarlett; Miller, Todd S.

doi:10.1097/aog.0b013e318242d8d4

Cited by 20 publications

(15 citation statements)

References 7 publications

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“…Maderia et al described a 38 year old woman in her fifth pregnancy at 21 weeks gestation who presented with headache and a spontaneous left internal carotid artery dissection involving the petrous and cavernous segments on MRI. In addition 22 cases of postpartum carotid artery dissection have been reported [3,4]. There was an even distribution of vaginal and caesarean deliveries, the time from delivery to onset of symptoms ranged from 2 – 21 days.…”

Section: Discussionmentioning

confidence: 99%

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Internal carotid artery dissection following chiropractic treatment in a pregnant woman with Systemic Lupus Erythematosus

Morton

2012

Chiropr Man Therap

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A case of internal carotid artery dissection in a pregnant woman with Systemic Lupus Erythematosus (SLE) immediately following chiropractic treatment is presented. The literature regarding complications of neck manipulation during pregnancy, spontaneous dissection of craniocervical arteries in pregnancy and the postpartum period, and dissection of craniocervical arteries in SLE are reviewed. To the best of the author’s knowledge, this is the first case of carotid artery dissection following chiropractic treatment in a pregnant woman published in the literature.

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Section: Discussionmentioning

confidence: 99%

“…Possible predisposing factors to arterial dissection in the peripartum period include intimal injury related to the Valsalva manoeuver during labour, alterations in arterial wall integrity due to pregnancy-related hormonal or vasoactive substances, increase in cardiac output and blood volume and the hypercoaguable state of pregnancy [4]. …”

Section: Discussionmentioning

confidence: 99%

Internal carotid artery dissection following chiropractic treatment in a pregnant woman with Systemic Lupus Erythematosus

Morton

2012

Chiropr Man Therap

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“…Only in two cases could the effect of positive intrathoracal pressure (Valsalva manoeuvre) during labour be dismissed because the childbirth was performed by the planned caesarean's section. In the other two cases, the labour was performed by caesarean's section after an unsuccessful vaginal delivery (5)(6)(7)(8)(9)(10)(11)(12)(13)(14)(15).…”

Section: Discussionmentioning

confidence: 99%

Dynamic Nature of Postpartal Carotid Artery Dissection

Vukicevic¹,

Brkić

Ducic³

et al. 2016

Serbian Journal of Experimental and Clinical Research

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ABBREVIATIONS CCAD -craniocervical carotid artery dissectionCTA -computed tomography angiography DSA -digital selective angiography ICA -internal carotid artery MRA -magnetic resonance angiography АBSTRACT Craniocervical carotid artery dissection (CCAD) is an important cause of stroke in young adults, but it has rarely been reported as a cause of stroke in puerperium.We We report the case of a 27-year-old female with a hi i is s sof migraine who presented with unilateral left hea ad a a atransient episodes of dysphasia and right hemipar r re r sis ys after vaginal delivery. Th e fi rst symptoms started ed ed d ed six after the pro o o ol lo lo lo l ng ng ng ged ed ed ed childbirth. Th e fi rst magnetic c c c c resoangiogra a a a ap p ph p p y revealed ed d ed d d d d d dis is is is issection in the sup p up up upra a ra rac clinoid cavern n n no o ou o s se se se se segm gm g g g en en nt t t t of of of of of t the lef f f ft t t t t In In In nte te ternal al al al a c carotid artery . We fo fo fo o foll ll ll l lo o ow o ed d d d up the pa a a ati t t t en n n nt t t t t for two years and she had stabl l le e e e e co o o our u u se. During this time e e e, , , she had occlusion of the clinoid segment of the left ICA, with caudal extension e ext x x x x ra r r r cranial segment and re eca a analisation one month T T Two w w w m m m m mon onth th ths s la la late ter, r, s she he he h h had ad ad i int ntrac cranial extension with ti i i i ion n n n o o o of f f the left anterior cere e ebr br bra a al artery. During this s s she s su s s s ff ff ff ff ffer e e ed from two stroke e e e es s s s w w wi w w th minimal neurologim mp pa p irme m me me ment nt nt nt t a a and good clinic ic ic ca a al r r r r recovery. The pathop p phy hy hy hy hysi si si iol ol l ol log o og og ogy y y of of of C C CCA CA CA CA AD D D D appears to be multifactoVessel el el w w w wal al a a l injury r l l l elated to the Valsalva manoeuvre durbour, as wel l ll l l l as as as a h h h hemodynamic and hormonal changes of ssel wall related to pre e e egn gn gn gn g an a cy in a patient with a history graine, may be causes of p p po p p stpartum spontaneous crarvical artery dissection in h h

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“…Also, carotid artery dissection can result from trauma; very simple trauma like hyperextension of the neck during athletic activities can also result in dissection of carotid arteries 6. Infection and minor trauma result in transient vasculopathy causing damage to endothelium and also intrinsic factors controlling vessel wall integrity can be affected by strenuous activity and major trauma thus explaining other possible mechanisms of dissection 2 3…”

Section: Case Presentationmentioning

confidence: 99%

“…There are no case reports of young pregnant patients with spontaneous carotid artery dissection. Some case reports of pregnancy on background of systemic lupus erythematosis and postpartum cases of spontaneous carotid artery dissection have been described 2 3…”

Section: Introductionmentioning

confidence: 99%