Acute Ischemic Stroke Due to Spontaneous Internal Carotid Artery Dissection in a Human Leukocyte Antigen (HLA) B27 Young Male

Muhammad Rezeul Huq,Humayun Kabir,Md Ismail Chowdhury,Ghulam Kawnayn

doi:10.7759/cureus.22963

Abstract

Carotid artery dissection is a significant cause of stroke in young patients. Here, we report a 33-year-old male who presented with right homonymous hemianopia and paresthesia of the right side of the body. Magnetic resonance imaging (MRI) of the brain revealed an acute infarct in the left parieto-occipital region. Magnetic resonance angiography (MRA) and duplex ultrasonography (USG) of the neck vessels suggested the left internal carotid artery dissection as the underlying cause. The patient was a known human leukocyte antigen (HLA) B27 and had a history of a previous attack of uveitis. This case report will raise awareness regarding the possible association of HLA B27 with the dissection of neck vessels.

Highlights

In a patient with less than 50 years, acute stroke is called the young-onset stroke [1]
Hypertension, migraine, infection, underlying diseases involving arterial wall morphology like fibromuscular dysplasia, Marfan's syndrome, homocysteinemia, Ehler's Danlos syndrome are significantly associated with carotid arterial dissection
internal carotid artery dissection (ICAD) is an important cause of ischemic stroke, especially in young patients

Summary

Introduction

In a patient with less than 50 years, acute stroke is called the young-onset stroke [1]. The visual disturbance was limited to the right visual field of both eyes, leading to bumping into different objects or door during walking He had no weakness of limbs, unconsciousness, dysphagia, dysarthria, or incontinence. He cannot recollect any definite trauma or injury to the neck He suffered from right-sided acute anterior uveitis a few years back. He was found to be HLA B27, asymptomatic, without any ocular or extraocular manifestations. The source image of the magnetic resonance angiography (MRA) of the neck revealed the thrombus in the left ICA (Figure 1B). How to cite this article Huq M, Kabir H, Chowdhury M, et al (March 08, 2022) Acute Ischemic Stroke Due to Spontaneous Internal Carotid Artery Dissection in a Human Leukocyte Antigen (HLA) B27 Young Male. He had no new complaints when he came for follow-up after three months

Discussion

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Disclosures

Sheehan NJ