Carotid and vertebral artery dissection syndromes

Thanvi, Bhomraj; Munshi, S K; Dawson, Suzanne L.; Robinson, Thompson G.

doi:10.1136/pgmj.2003.016774

Cited by 171 publications

(190 citation statements)

References 53 publications

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“…Penetrating neck injuries, cervical spine dislocation and birth trauma are the major factors that lead to traumatic injury to the oculosympathetic pathway 7,9 . A history of trauma preceding these fi ndings should prompt the clinician to consider that the carotid artery, which lies directly over the sympathetic chain in the neck, may have been injured, particularly if signs of head or neck trauma are present 8,10,11 . The investigation of choice considered by some authors is a magnetic resonance imaging and angiography scan of the head and neck 10 .…”

Section: Discussionmentioning

confidence: 99%

“…Diagnosis is namely based on clinical fi ndings, and after careful history and examination, the physician must decide whether further investigation is necessary. There is a wide variety of conditions that may cause this syndrome, postsurgical and iatrogenic causes comprise most of the cases [3][4][5][6][7][8] . Penetrating neck injuries, cervical spine dislocation and birth trauma are the major factors that lead to traumatic injury to the oculosympathetic pathway 7,9 .…”

Section: Discussionmentioning

confidence: 99%

See 1 more Smart Citation

Horner's syndrome after blunt cervical and chest trauma: case report

Paiva

Amorim

Tavares

et al. 2007

Arq. Neuro-Psiquiatr.

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-Horner's syndrome is the triad of miosis, ptosis, and anhidrosis, resulting from disruption of the sympathetic pathways. This article describes an uncommon case of Horner's syndrome in a 22-year-old man after blunt trauma to the neck and chest without carotid artery dissection. The patient was brought to the emergency service after motorcycle fall. Neurologic examination revealed a patient presenting the score 15 at Glasgow Coma Scale. The left eyelid was 1-2 mm lower than the right. Carotid Doppler and angiotomography were undertaken and revealed no abnormalities of the carotid artery. CT disclosed a mediastinal hematoma extending to the left apex, compressing the left sympathetic chain. The understanding of this clinical entity may help the surgeon to make a better differential diagnosis in trauma patients in whom prompt diagnosis is critical to stablish the correct treatment.KEY WORDS: Horner syndrome, trauma, etiology. Síndrome de Horner após trauma cérvico-torácico fechado: relato de casoRESUMO -A síndrome de Horner compreende a tríade de miose, ptose e anidrose, resultado de lesão em algum ponto das vias simpáticas. O referido estudo apresenta um caso da referida síndrome em um jovem de 22 anos vitima de queda de moto, com escoriações no tórax e no pescoço, sem dissecção carotídea. Ao exame neurológico, encontrava-se com 15 pontos na Escala de Coma de Glasgow, com miose à esquerda e ptose palpebral ipsilateral. Realizado Doppler de carótidas e angiotomografia dos vasos cérvico-cranianos não sendo evidenciadas anormalidades. A tomografia de tórax mostrou um hematoma no ápice pulmonar esquerdo, comprimindo a cadeia simpática ipsilateral. O conhecimento desta entidade clínica pode ajudar o cirurgião a fazer um diagnóstico diferencial adequado nos pacientes vítimas de traumas, nos quais o diagnóstico correto e eficaz pode ser fundamental para a definição da conduta a ser tomada. Campos, Horner's syndrome consists of a triad of symptoms (miosis, ptosis, and anhydrosis) resulting from disruption of the sympathetic pathways somewhere between the brain and the eyes. In blunt trauma, it is usually associated with carotid artery dissection. Although the individual signs of Horner's syndrome do not constitute an emergency, the internal carotid artery proximity to the sympathetic ganglia makes Horner's syndrome a potential vascular emergency [1][2][3] . PALAVRAS-CHAVE Dr. Wellingson Paiva -Rua Ovidio Pires deWe present a case of Horner's syndrome in a 22-year-old man after blunt trauma to the neck and head unrelated to carotid artery dissection. CASEA 22-year-old man was brought to the emergency room after motorcycle fall, with history of transitory loss of conscience. In the admition, he was alert and orientated, the carotid pulses were symmetric, regular in rate and rhythm, with no bruits and the chest and the abdomen had no signs of abnormalities. The patient related moderate cervical pain but no neurological defi cits were noticed except for the asymetric pupils that measured 5 mm on the right and 2 mm ...

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Horner's syndrome after blunt cervical and chest trauma: case report

Paiva

Amorim

Tavares

et al. 2007

Arq. Neuro-Psiquiatr.

View full text Add to dashboard Cite

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“…subacute m (see Figure Figure 1. infarcts wi ery is relatively f 35 and 50 [2] nger than men [ cause 20% o the cervical reg the arterial lay l artery stenosi he media and dissection origin edia [6] . VAD Internatio n the axial plane ebral arteries; B: al arteries bilater n arrows) nstrating resolve aliber (arrows) y uncommon, w .…”

Section: Case Reportmentioning

confidence: 99%

Symptomatic bilateral extra-cranial vertebral artery dissections induced by sexual activity

Michael

Calvin

Christopher

et al. 2016

IJDI

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Introduction: Trauma is a well-recognized cause of vertebral artery dissection (VAD) and even minor episodes of trauma, including sneezing and vigorous exercise, have been implicated. Symptomatic bilateral vertebral artery dissections after sexual activity to our knowledge has not been reported. Case report:A 32-year-old female presented with a three week history of occipito-cervical headaches. Noninvasive imaging identified bilateral vertebral artery dissections. The etiology was inferred after a directed clinical history revealed sexual activity characterized by aggressive repeated neck hyperextension from hair-pulling during intercourse. Conclusion:We report a case of symptomatic bilateral VAD in the setting sexual intercourse related trauma. The quality of clinical data gathering, in particular pertinent history taking is imperative in determining a potential cause. This is important in patient counselling so as to prevent recurrence.

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“…More than 50% of intracranial VADs are associated with subarachnoid hemorrhage (SAH) 40) . Since Yonas et al 43) described the pathological and radiographic features of intracranial dissecting aneurysm as a cause for SAH, it has been increasingly recognized as a cause of SAH with a unfavorable prognosis and a high rate of rebleeding.…”

Section: Intracranial Vadsmentioning

confidence: 99%

“…This causes stenosis of the lumen when blood collects between the intima and media or an aneurysmal dilatation of the artery when the hematoma predominantly involves the media and adventitia 40) . This process was long thought to be a rare cause of stroke, particularly in the absence of trauma, and the diagnosis was usually not made until the postmortem examination 11,30) .…”

Section: Introductionmentioning

confidence: 99%