Extracranial Internal Carotid Artery Dissections

Zelenock, Gerald B.

doi:10.1001/archsurg.1982.01380280023006

Cited by 107 publications

(37 citation statements)

References 48 publications

(1 reference statement)

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“…Authors of small series only have reported the use of ultrasonography in the diagnosis and follow-up of CADs. 10,60,64,67,71 Duplex ultrasonography provides high-resolution real-time images of the CA bifurcation and proximal internal CA and has proved reliable in evaluating the presence and severity of atherosclerotic disease. Ultrasonography is noninvasive and more widely available than conventional angiography or MR angiography.…”

Section: Diagnosis Of Cadmentioning

confidence: 99%

Extracranial traumatic carotid artery dissections in children: a review of current diagnosis and treatment options

Chamoun

Mawad

Whitehead

et al. 2008

PED

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Object Currently, no diagnostic or treatment standards exist for extracranial carotid artery dissection (CAD) in children after trauma. The purpose of this study was to review and describe the characteristics, diagnosis, and treatment of this rather uncommon sequelae of pediatric trauma. Methods A systematic review of the literature was performed to examine the pertinent studies of traumatic extracranial carotid artery (CA) injuries in children. Results No randomized trials were identified; however, 19 case reports or small case series consisting of 34 pediatric patients were found in the literature. The diagnosis of CAD was made in 33 of 34 patients only after the onset of ischemic symptomatology. Twenty-four of 34 patients underwent cerebral angiography to confirm diagnosis; MR angiography affirmed the diagnosis in 6 of 34 patients. There was little published experience with CA ultrasonography or CT angiography for diagnosis. Thirty of 34 patients were treated with medical therapy or observation; 2 of 4 patients treated with observation alone died. There was little experience with open surgical treatment of CAD in the pediatric population, and there were no studies on the endovascular treatment of traumatic CAD in children. The literature does not support anticoagulation therapy over antiplatelet therapy. Conclusions As a result of this review of the literature, the authors propose the algorithms for the evaluation and treatment of traumatic extracranial CADs in children. These recommendations include utilizing MR angiography as a screening tool in cases in which the clinical suspicion of CAD is high, using conventional cerebral angiography to confirm the diagnosis, implementing antiplatelet therapy as initial medical management, and reserving endovascular stenting in cases of failed medical treatment.

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Section: Diagnosis Of Cadmentioning

confidence: 99%

Extracranial traumatic carotid artery dissections in children: a review of current diagnosis and treatment options

Chamoun

Mawad

Whitehead

et al. 2008

PED

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“…Dissection of the ICA is caused by numerous factors including direct trauma (blunt or sharp), 17 mechanical compression or stretching, 18 spontaneous, 19 -20 or sec- 2122 Traumatic and spontaneous dissections occur most frequently at the C|-C 2 level and may propagate proximally or distally. 22 Vertebral dissections also commonly occur at the C 6 level where the artery enters the foramen transversarium.…”

Section: ~3mentioning

confidence: 99%

Angiography of nonhemorrhagic cerebral infarction in young adults.

Smoker¹,

Biller²,

Hingtgen³

et al. 1987

Stroke

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The radiographic examinations and hospital records of 93 young adult patients (15-45 years of age) with nonhemorrhagic cerebral infarction evaluated at our institution during the past 9 years were reviewed. The angiographic examinations were abnormal in 76% of patients. The most common abnormalities were embolic disease and atherothrombotic disease. Forty-seven patients underwent angiography within 7 days of their event. There were no major neurologic or systemic complications related to early angiography. We believe that angiography performed early in the course of the illness is a high-yield, safe procedure that may significantly alter the management of acute stroke in young adults. (Stroke 1987;18:708-711)

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“…The former was probably responsible for the carotid artery dissection in the present case. (9) In the majority of BCVI cases, the pathological background is disruption to the intima, which causes luminal narrowing or even occlusion due to the collapse of the false lumen against the true lumen. The exposed sub-endothelial collagen promotes platelet aggregation and thrombus formation that can lead to embolization.…”

Section: Discussionmentioning

confidence: 99%