Presentation of cerebral and cervical arterial dissections in Botucatu, Brazil: case series.

Gabriel Pinheiro Modolo,Niura Aparecida De Moura Ribeiro Padula,Gustavo José Luvizutto,Elaine Keiko Fujisao,Felipe Aranibar Soares Da Silva,Rodrigo Bazan,Carlos Clayton Macedo De Freitas,Marcone Lima Sobreira

doi:10.1590/1677-5449.200242

Abstract

Spontaneous dissection of the cervical and cerebral arteries is an important cause of stroke and disability in young patients. In this report, the authors present a case series of patients with spontaneous carotid, vertebral, or cerebral artery dissection who underwent digital angiography. A review of the published literature on this subject is also presented.

Highlights

Spontaneous dissection of the carotid and vertebral arteries is responsible for 2% of all ischemic strokes, with higher occurrence in young people,[3,4] affecting their most productive years.[5,6,7,8]
Sudden onset neck pain associated with nausea, vomiting, and signs of neurological deficits are strong indicators of cervical artery dissection
In cases of dissection with pseudoaneurysm, the signs and symptoms were associated with subarachnoid hemorrhage (SAH) and impaired consciousness

Summary

Introduction

Cerebrovascular disease is the leading cause of severe disability and mortality in Brazil.[1,2] Spontaneous dissection of the carotid and vertebral arteries is responsible for 2% of all ischemic strokes, with higher occurrence in young people,[3,4] affecting their most productive years.[5,6,7,8]The most common risk factors include arterial hypertension, smoking, dyslipidemia, fibromuscular dysplasia, collagen disorders, trauma, and migraine with aura.[3,7,9,10,11] Sudden onset neck pain associated with nausea, vomiting, and signs of neurological deficits are strong indicators of cervical artery dissection. Cerebrovascular disease is the leading cause of severe disability and mortality in Brazil.[1,2] Spontaneous dissection of the carotid and vertebral arteries is responsible for 2% of all ischemic strokes, with higher occurrence in young people,[3,4] affecting their most productive years.[5,6,7,8]. Dissection leads to formation of a mural hematoma, resulting in vascular stenosis, pseudoaneurysm, and eventual rupture of the vessel.[10] the clinical presentation may indicate a serious condition such as stroke or subarachnoid hemorrhage (SAH), prognosis and recovery are typically positive and most patients achieve functional independence.[5,6,7] In addition, the incidence of recurrent stroke in these patients is usually low.[12]

Objectives

Results

Conclusion