Ischemic Stroke Due to Spontaneous Dissection of the Brachiocephalic to the Common Carotid Artery with a Fatal Course after Expansion to the Ascending Aorta

Abstract

Spontaneous dissection of the brachiocephalic artery is rare, and there is insufficient evidence for optimal treatment. We herein report a case of ischemic stroke due to spontaneous dissection of the brachiocephalic to the right common carotid artery. The patient was treated medically but died suddenly 18 days after the onset because of aortic dissection. Although almost all reported cases of spontaneous dissection of the brachiocephalic artery have had good outcomes with medical management, it is important to note that sudden development of aortic dissection might occur, even without initial findings suggestive of this condition.

A Rare Case of Isolated Spontaneous Common Carotid Artery Dissection Treated by Telescoping Stents

“…The pathophysiology for isolated spontaneous CCA dissection is not well known but it seems to be multifactorial, including familial and genetic predispositions and other risk factors, such as hypertension, hyperlipidemia, infections, and uncommon connective tissue diseases [3,6]. In the current case, the patient was already diagnosed with hypertension and hyperlipidemia, but the CCA dissection occurred spontaneously without any traumatic events even after regular medications and work-ups on the cardiac status.…”

“…Spontaneous carotid dissection can be an important cause of stroke usually in the young population, and it is encountered usually in the cervical segment of the internal carotid artery (ICA). Spontaneous dissection of the common carotid artery (CCA) is an extremely rare cause of ischemic stroke [1][2][3][4][5][6]. Most CCA dissections are caused by an extension of an aortic dissection, and direct traumas and iatrogenic etiologies, such as vascular procedures, are known to be relatively less common causes [1,[7][8][9][10][11].…”