Severe ischemic stroke due to progression of cervical carotid artery dissection

Nobuhiro Inoue,Yukiko Ueno,Shuhei Fuyuta,Yusuke Kakizoe,Michiya Iwata,Osamu Kobayashi,Sueyoshi Hiroyuki,Kitajima Mika,Kawano Takayuki,Tomomi Ikeda,Shingo Fukuda,Esra Dogru Huzmeli

doi:10.14302/issn.2470-5020.jnrt-17-1733

Nobuhiro Inoue, Yukiko Ueno + Show 10 more

Open Access

https://doi.org/10.14302/issn.2470-5020.jnrt-17-1733

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Abstract

Severe ischemic stroke due to progression of cervical carotid artery dissection

Highlights

Earlier population-based studies on the incidence cervical internal carotid artery (ICA) dissection revealed an annual incidence rate of 2.6 - 2.9 per 100,000 individuals
A T1-volumetric isotropic turbo spin echo acquisition (VISTA) sequence resulted in the diagnosis of dissection of the cervical segment of the internal carotid artery (CS-ICA) (Fig. 1C)
An intensive rehabilitation has been continued for him after operation. His functional independence measure (FIM) score recorded over the course of 4 months showed remarkable improvement ( Fig. 3) as did the standard language test for aphasia

Summary

Introduction

Earlier population-based studies on the incidence cervical internal carotid artery (ICA) dissection revealed an annual incidence rate of 2.6 - 2.9 per 100,000 individuals. Cervical ICA dissection is among the most common contributors to stroke in young and middle-aged adults (under 45 years) without vascular risk factors. They are less likely to have cerebrovascular atherosclerosis; approximately 2% of overall ischemic stroke is seen in that population.[1,2,3,4,5] Vertebral artery dissection (VAD) tends to be less common than cervical ICA dissection in Europe and America, reliable epidemiologic data are not available.[6,7,8] According to a Japanese study, the most common site of dissection in the Japanese was the intracranial vertebro-basilar artery;[9] dissection of the cervical segment of the internal carotid artery (CS-ICA) is rarely encountered. As most patients tend to do well regardless of the type of treatment,[8,10,13] identification of the optimal treatment in patients with ICA dissection is difficult.[6,14,15] We encountered a 43year-old Japanese male with sudden-onset severe ischemic stroke attributable to the progression of spontaneous dissection of the CS-ICA that had been diagnosed 3 weeks earlier

Case Report

Findings

Discussion