Spontaneous Carotid Dissection With Acute Stroke

Bogousslavsky, Julien; Despland, P. A.; Régli, F

doi:10.1001/archneur.1987.00520140009010

Cited by 308 publications

(172 citation statements)

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“…Strokes in young adults resulting from spontaneous dissection of the cervical segment of the extracranial carotid artery are being reported with increasing frequency [1][2][3][4][5][6][7][8] . Ischemia may result from occlusion of the internal carotid artery (ICA) and distal stump embolization to the distal intra-cranial arteries, and may account for major morbidity and mortality in young stroke victims.…”

mentioning

confidence: 99%

Thrombolytic therapy for acute extra-cranial artery dissection: report of two cases

Zaidat

Filho

Singh

et al. 2001

Arq. Neuro-Psiquiatr.

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-Extra-cranial arterial dissection accounts for 10% of strokes in young people. Information on safety of thrombolytic administration in this group is limited. The literature, however, does not favor use of thrombolytics for myocardial ischemia when peripheral arterial dissection coexists. Based on the clinical and radiological features, two patients who presented with acute stroke secondary to arterial dissection were considered for thrombolysis. One of them received intra-venous recombinant tissue plasminogen activator (rtPA), and the other patient received intra-arterial rtPA. There were no post thrombolysis complications. This report supports feasibility of administering thrombolytics in acute ischemic strokes resulting from extra-cranial arterial dissection. Future larger studies are necessary to determine the efficacy, safety and long-term outcome in this patient population.KEY WORDS: thrombolysis, stroke, dissection, internal carotid artery. Terapia trombolítica em dissecções arteriais cérvico-cefálicas agudas: relato de dois casosRESUMO -Dissecção arterial cérvico-cefálica corresponde a 10 % dos acidentes vasculares cerebrais (AVC) em jovens. Informação sobre a segurança da administração de trombolíticos neste grupo é limitada. A literatura médica, entretanto, não favorece o uso de trombolíticos em isquemia miocárdica na coexistência de dissecção arterial periférica. Baseado nas características clínicas e radiológicas, dois pacientes com AVC agudo secundário a dissecção arterial foram considerados para terapia trombolítica. Um deles recebeu rtPA intravenoso e o outro paciente recebeu rtPA intra-arterial. Não houve complicações pós-trombólise. Este relato suporta a possibilidade do tratamento destes pacientes com terapia trombolítica. Estudos maiores são necessários para determinar a eficácia, segurança e resultados a longo prazo nesta população de pacientes. PALAVRAS-CHAVE: trombólise, acidente vascular cerebral, dissecção, artéria carótida interna.

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mentioning

confidence: 99%

Thrombolytic therapy for acute extra-cranial artery dissection: report of two cases

Zaidat

Filho

Singh

et al. 2001

Arq. Neuro-Psiquiatr.

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“…One of our patients had ischemic optic neuropathy (ION), combined with Horner's syndrome. Only ten cases are previously published with ION due to ICA dissection (Mokri et al1996, Bogousslavsky et al 1987, McNeill et al 1980, Newman et al 1989, Rivkin et al 1990, Tsai & Sun 1997, Biousse et al 1998). Four patients are described as having anterior ischemic optic neuropathy with optic disc swelling, and four other with posterior optic neuropathy, without detectable optic disc changes.…”

Section: Discussionmentioning

confidence: 99%

“…Trivial trauma during head turning or during different sport activities could account for some of the dissections categorised as spontaneous (Bogousslavsky et al 1987). Different data suggest a transient vasculopathy of an as yet undetermined origin.…”

Section: Discussionmentioning

confidence: 99%

The ophthalmology of internal carotid artery dissection

Kerty¹

1999

Acta Ophthalmologica Scandinavica

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ABSTRACT.Purpose: Carotid dissection is an important cause of cerebral and retinal ischemic symptoms, especially in young adults. This article presents a patient material and also includes a review of the ophthalmologic signs and symptoms of carotid dissection. Material and methods: Twenty-eight patients with spontaneous dissection of the extracranial internal carotid artery dissection underwent a neuro-ophthalmological examination. Results: Twenty-three patients had oculosympathetic paresis. Two experienced transient monocular blindness; in one the episodes were provoked by sitting up from a supine position. One patient presented with a monocular visual field defect, due to posterior ischemic neuropathy, and two others with homonym hemianopia. Diplopia, caused by an incomplete VIth cranial nerve palsy was recognised in one. Conclusion: All but one patient presented with detectable ophthalmologic symptoms or signs. Very often the ophthalmologist is the first medical contact for patients with internal carotid artery dissection. The condition is serious, and a prompt evaluation and treatment is indicated to prevent irreversible sequelae.

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“…Miyoz, pitoz ve anhidroz ile karakterize olan Horner sendromunun İCA diseksiyonunda görülme oranı % 58 dolaylarındadır (15 Sonuç olarak, ICA diseksiyonu Horner sendromu ve/veya alt kranyal sinir felçleri ile sık olmasa da karşımıza çıkabilir. Her genç hastada akla gelmek üzere özellikle de nörolojik muayene bulguları görüntülenen enfarktı açıklamadığı koşullarda, travma ya da boyun ağrısı anamnezi alınmıyorsa da diseksiyon mutlaka akla gelmesi gereken nedenlerden biri olmalıdır.…”

Section: Olgu Sunumuunclassified

An internal cerebral artery dissection presented with anterior choroidal artery infarction

Çoban¹,

İçen²,

Soysal³

2012

Türk Beyin Damar Hast Derg

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ÖZETAnterior koroidal arter ( AChA) internal karotis arterin (ICA) dalı olup en sık laküner sendrom kliniği ile prezente olur. En sık gözlenen nörolojik bulgu hemiparezidir. Horner sendromu ve alt kranyal sinir felçleri izole AChA enfarktları için beklenen bulgular değildir. Bu klinikle karşılaşılan AChA enfarktı olan hastada altta yatan etyolojik neden gözden geçirilmelidir. 42 yaşında erkek hasta hastanemiz nöroloji kliniğine sağ hemiparezi nedeni ile yatırıldı. Nörolojik muayenesinde Horner sendromu ve hipoglossal sinir felci tespit edildi. Kranyal ve Difüzyon Magnetik rezonans görüntülemesinde (MR) sol AChA alanında akut enfarktı gözlendi. Ekstrakranyal MR Anjiografisinde sol İCA distal servikal ve proksimal petrozal kesiminde fokal kalibrasyon incelmesi tespit edilmesi üzerine hastaya Dijital Substraksiyon Anjiografisi (DSA) yapıldı. Sol İCA subpetröz segmentte diseksiyon tespit edildi. Hastaya oral antikoagülan tedavi başlandı. ICA diseksiyonu Horner sendromu ve/veya alt kranyal sinir felçleri ile sık olmasa da karşımıza çıkabilir. Özellikle genç hastalarda travma ya da boyun ağrısı anamnezi alınmasa bile diseksiyon mutlaka akla gelmesi gereken neden olmalıdır. Anahtar Sözcükler: Horner sendrom, karotis diseksiyon, hipoglossal sinir, anteriyor koroidal arter enfarktı. AN INTERNAL CEREBRAL ARTERY DISSECTION PRESENTED WITH ANTERIOR CHOROIDAL ARTERY INFARCTION ABSTRACTAnterior choroidal artery (AchA) is a branch of internal carotid artery. AchA infarcts are frequently presented by lacunar syndromes. Hemiparesis is the most common presenting symptom. Horner syndrome and cranial nerve palsies are unusual findings for AChA infarcts. In case of presentation with these, etiopathogenesis should be reconsidered and reevaluated. A 42 year old man was admitted to our neurology clinic with right hemiparesis. He had Horner syndrom and hypoglossal nerve palsy. An acute AChA infarction was seen in cranial and diffusion-weighted magnetic resonance imaging (MRI). As there was a suspicious sign of carotid dissection in extracranial MR angiography, digital substraction angiography was performed and dissection of left carotid artery in the subpetrosal region was observed. The patient was diagnosed with left carotid artery dissection and was started on oral anticoagulan therapy. Presentation of an acute AChA infarction due to the dissection of ICA is rarely observed. ICA dissections can sometimes be presented by Horner syndrome and/or cranial nerve palsies. Especially in young stroke patients, dissection should be considered even if the patient does not mention headache. Key Words: Horner syndrome, carotid dissection, anterior choroidal artery infarct, hypoglossal nevre. GİRİŞAnterior koroidal arter (AChA) internal karotis arterin (ICA) dalı olup, sıklıkla supraklinoid bölümünden orta ve ön serebral arter bifurkasyonundan hemen önce doğar. AchA enfarktlarının prevalansı oldukça düşük olup % 3'ün altındadır (1). Oxfordshire Community Stroke Project (OCSP) kriterlerine göre % 83 olgu laküner sendrom kliniği ile prezente olmaktadı...

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Spontaneous Carotid Dissection With Acute Stroke

Cited by 308 publications

References 27 publications

Thrombolytic therapy for acute extra-cranial artery dissection: report of two cases

Thrombolytic therapy for acute extra-cranial artery dissection: report of two cases

The ophthalmology of internal carotid artery dissection

An internal cerebral artery dissection presented with anterior choroidal artery infarction

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