Carotid Artery Dissection Research Articles

Simultaneous spontaneous dissection of right carotid and left vertebral artery followed by spontaneous coronary artery dissection in a patient with renal fibromuscular dysplasia and aneurysm.

Simultaneous spontaneous dissection of right carotid and left vertebral artery followed by spontaneous coronary artery dissection in a patient with renal fibromuscular dysplasia and aneurysm.

Isolated Hypoglossal Nerve Palsy due to Spontaneous Internal Carotid Artery Dissection: Two Cases Report and Review of the Literature

We report on 2 patients who presented to the ear, nose, and throat (ENT) clinic. Clinical examination demostrated tongue deviation towards the left side, without other neurological symptoms. Imaging studies, Neck CT and MR angiograms, revealed intramural haematoma, thickening and stenosis of the right distal extracranial internal carotid artery (ICA) consistent with spontaneous dissection.

Bilateral internal carotid artery dissection in a patient with Eagle’s syndrome

Angiología es una revista científica bimensual editada desde 1949. Está dedicada al estudio de las enfermedades vasculares, incluyendo todos los aspectos de la medicina vascular, el diagnóstico no invasivo, el tratamiento quirúrgico tradicional arterial y venoso, así como el mínimamente invasivo y/o endovascular.

A case of ruptured dissecting vertebral artery aneurysm with cerebral infarction due to cervical internal carotid artery dissection

A case of ruptured dissecting vertebral artery aneurysm with cerebral infarction due to cervical internal carotid artery dissection

Persistent intramural hematoma secondary to internal carotid artery dissection

Persistent intramural hematoma secondary to internal carotid artery dissection

Persistent primitive trigeminal artery played a role as a collateral pathway in spontaneous internal carotid artery dissection: a case report

Persistent primitive trigeminal artery played a role as a collateral pathway in spontaneous internal carotid artery dissection: a case report

A Case of Endovascular Surgery on an Intracranial Large Vessel Occlusion due to Cervical Internal Carotid Artery Dissection with an Arterial Tortuosity and Thrombus

A Case of Endovascular Surgery on an Intracranial Large Vessel Occlusion due to Cervical Internal Carotid Artery Dissection with an Arterial Tortuosity and Thrombus

Stent Placement for Ischemic Intracranial Carotid Artery Dissection in a Patient with COVID-19

Stent Placement for Ischemic Intracranial Carotid Artery Dissection in a Patient with COVID-19

Clinical Features and Treatment of Spontaneous Cervical Internal Carotid Arterial Dissection

Clinical Features and Treatment of Spontaneous Cervical Internal Carotid Arterial Dissection

Carotid Endarterectomy for Effective Management of Traumatic Extracranial Carotid Artery Dissection following a Penetrating Neck Injury : A Case Report

Carotid Endarterectomy for Effective Management of Traumatic Extracranial Carotid Artery Dissection following a Penetrating Neck Injury : A Case Report

Carotid Artery Dissection and Ischemic Stroke Following Cervical Chiropractic Manipulation: Two Case Reports

Patients can be at risk of carotid artery dissection and ischemic stroke after cervical chiropractic manipulation. However, such risks are rarely reported and raising awareness can increase the safety of chiropractic manipulations. We present two middle-aged patients with carotid artery dissection leading to ischemic stroke after receiving chiropractic manipulation in Foshan, Guangdong Province, China. Both patients had new-onset pain in their necks after receiving chiropractic manipulations. Excess physical force during chiropractic manipulation may present a risk to patients. Patient was administered with recombinant tissue plasminogen activator after radiological diagnoses. They were prescribed 100mg and clopidogrel 75mg daily for 3months as dual antiplatelet therapy. There were no complications over the follow-up period. These cases suggest that dissection of the carotid artery can occur as the result of chiropractic manipulations. Patients should be diagnosed and treated early to achieve positive outcomes. The safety of chiropractic manipulations should be increased by raising awareness about the potential risks.

Safety and Feasibility of Reconstructing Dissection Tandem Lesions with Flow Diverter Stents during Mechanical Thrombectomy for Acute Ischemic Stroke: A Multicenter Retrospective Case Series

Background Patients with acute ischemic stroke due to large vessel occlusion may present with concomitant carotid dissections that make the technical approach for their treatment challenging. The purpose of this study was to determine the safety and feasibility of flow diverter (FD) stents to treat carotid artery dissections in tandem lesions of acute ischemic stroke patients during mechanical thrombectomy. Methods A retrospective review of all patients in which a carotid artery dissection was treated with an FD during endovascular treatment of acute ischemic stroke between 2018 and 2020 was conducted in 5 high‐volume Comprehensive Stroke Centers. Patient clinical and angiographical characteristics, postoperative outcome, and follow‐up were recorded. Results A total of 12 patients (mean age: 54.18±14.74 years, median Alberta Stroke Program Early CT Score: 10 [interquartile range 9–10]) were included. Successful FD stenting with immediate patency of the dissected segments and successful intracranial recanalization modified thrombolysis in cerebral infarction score 2b‐3 after thrombectomy was achieved in all patients. A good outcome (modified Rankin scale 0–2 at 90 days) was achieved in 66% (8/12) of patients. In 25% (3/12) of patients, an additional self‐expanding carotid stent was used to anchor the FD proximally at the carotid bulb level. Complications included 1 symptomatic intracranial hemorrhage after procedure (24–48 hours) and 2 in‐stent stenoses at follow‐up. Conclusions In this small case series, the treatment of carotid artery dissection with FD stents was safe and technically feasible during mechanical thrombectomy of acute ischemic stroke patients with tandem lesions and resulted in a high rate of good clinical outcome. These results may provide the basis for designing larger prospective studies to assess the efficacy and safety of FD stents in selected patients with carotid tandem lesions.

Acute Retinal Arterial Infraction

Severe retinal arteriolar infarction, also known as transitory one eye vision loss, branch obstruction of retinal artery (BRAO), obstruction of main artery of retina, and ophthalmologic artery obstruction (OAO), is induced by an embolic event from the ipsilateral carotid artery, heart, or aortic arch, occluding the central retinal artery partially or completely Drastic retinal artery infraction, like drastic neuronal injury, is a medicinal and visual problem. Drastic retinal artery infraction puts patients at a high threat for cardiovascular diseases including strokes and infarctions. As a result, prompt diagnostic and referring to relevant specialists and tools are necessary for assigning (like brain MRI accompanied by diffuse gated scanning, arterial image analysis, and ecgs and electron microscopy) and possibly treatments of an emergency issue (for e.g dissection of carotid artery). Since its been not proved, efficient medications exist to improvise format after persistent ocular vascular infarction, additional preventative techniques should be adopted to limit the possibility of future ischemic events. CRAO, BRAO, cotton balls spots, and primary and secondary levels fugax are the four distinct kinds of amaurosis fugax. There are several therapeutic domains for both CRAO and BRAO. CRAO is categorized into 4 diagnostic categories, contrary to popular opinion: non-arteritis' CRAO, non-arteritis' CRAO with cilioretinal vascular avoidance, must CRAO accompanied with hyperplastic arteritis (GCA), and transient non-arterititic CRAO. The physiological phenomena that accommodate BRAO are persistent BRAO, temporary BRAO, and cilioretinal arterial obstruction (CLRAO). The different medical categories that constitute up BRAO are non-arteritic CLRAO alone accompanied with central visual vein obstruction, and arteritic CLRAO accompanied with GCA. It's crucial to define these categories in order to properly appreciate the complexities of these diseases. The pathogeneses, dispensary features, and management of the various types of central retinal infarcts (CRAO) are thoroughly discussed.

From the Expert's Office: Dissection of the Internal Carotid Artery and Cerebral Infarction after Manual Therapy - A Medical Malpractice

From the Expert's Office: Dissection of the Internal Carotid Artery and Cerebral Infarction after Manual Therapy - A Medical Malpractice

Assessment of association between the carotid web and dissection in spontaneous internal carotid artery dissection patients using vessel wall MRI.

Internal carotid artery dissection (ICAD) is the major cause of ischemic stroke in young to middle-aged people. Recognition of predisposing factors may facilitate in early individual risk prediction and expand treatment. To evaluate the association between a carotid web and dissection in patients with ICAD using vessel wall magnetic resonance imaging (VW-MRI). A retrospective study was conducted of 223 patients who underwent VW-MRI. Of these patients, 58 patients with craniocervical artery dissection (CCAD) (33 ICAD and 25 vertebrobasilar artery dissection [VBAD]) were included. The control group (n = 165) consisted of patients without arterial dissection who had undergone VW-MRI . The presence of a carotid web in the posterior aspect of carotid bulb was recorded. The distance between the carotid web and start of dissection in ICA was recorded. The presence of a carotid web showed a significant difference between the ICAD, VBAD, and control groups (19 [57.6%] vs. 5 [20%] vs. 36 [21.8%], respectively; P < 0.001). In multi-nominal analysis, the presence of a carotid web showed a significant difference between the ICAD and VBAD groups and the ICAD and control groups (P < 0.05), with odds ratios of 5.41 (95% confidence interval [CI]=1.634-17.973) and 4.81 (95% CI=2.176-10.651), respectively. Out of 19 ICAD patients with carotid web, 16 had occurrence of dissection in the C1 segment of the ICA with a mean distance of 1.91 ± 1.71 cm from the carotid web. Presence of a carotid web was more frequent in patients with ICAD. The carotid web may be one of the predisposing factors for development of dissection in patients with ICAD.

Endovascular revascularization for internal carotid artery dissection during stroke‐like episode in MELAS: A case report

AbstractA 45‐year‐old woman was admitted to our hospital because of speech difficulties. Initial magnetic resonance imaging (MRI) suggested subacute ischemic infarction in the left parietal to temporal area. Neurological examination on admission showed motor aphasia without any other deficits, and her symptoms gradually worsened with severe headaches. Nine days after admission, brain MRI revealed the development of an ischemic lesion, and magnetic resonance angiography (MRA) showed left internal carotid artery dissection. Emergency carotid stent placement was then performed on the stenotic lesion, which improved her severe headache. Based on her symptoms, she was diagnosed with mitochondrial myopathy, encephalopathy, lactic acidosis, and stroke‐like episodes (MELAS) after revascularization therapy. This is the first case in which acute endovascular revascularization was performed for internal carotid artery dissection in MELAS.

Free Falling: Characteristics and Prevention of Injury and Death in Extreme Aerial Sports Tourists

Extreme aerial sports are unique in terms of their high degree of lethality, life-changing injuries, and the lack of experience required by amateur participants. As society gradually re-emerges from the pandemic, we are likely to witness a renewed interest in outdoor adventure activities, including extreme aerial sports such as bungee jumping and skydiving. Sports physicians, general practitioners and travel medicine advisers should have a basic familiarity with the risks associated with bungee jumping and skydiving. Serious injury can occur during bungee jumping when the safety harness fails, the cord elasticity is miscalculated, or the cord is not properly connected to the platform. There is a predominance of ocular injuries, especially retinal haemorrhage. More severe non-fatal injuries include facet joint dislocation with quadriplegia, carotid artery dissection, and non-fatal hanging. The majority of adverse skydiving incidents occur during the landing phase and most injuries involve the lower extremities. When travelling as a skydiving tourist, individuals should carry documents explaining each aspect of the equipment and a note for security personnel. Tourists should check if their insurance covers skydiving. Future research should investigate the experiences of aerial sports tourists, in relation to the level of preparation and safety measures applied to their jumps.

The Eagle Has Landed: an unusual case of Eagle’s syndrome

Eagle’s syndrome refers to a group of characteristic symptoms affecting the oropharynx and neck that are caused by regional compression of structures due to a calcified stylohyoid ligament or an elongated styloid process. Of its two types, the former type is more common than the latter, but carotid artery dissection as a result of an elongated styloid is exceptionally rare. Following an extensive literature review, we present a case of carotid artery dissection causing multiple strokes secondary to direct compression from an elongated styloid process. Managed surgically through excision of the elongated styloid and post-operative rehabilitation, the patient recovered well and was discharged on anti-thrombotic medication, preventing further potentially detrimental attacks.

Presentation, Outcome, and Evolution of Vertebral and Carotid Dissections: A Prospective Registry: Supra-Aortic Arterial Disease

Introduction: Dissection of carotid and vertebral arteries is a rare condition, which possibly leads to stroke; however, the ideal therapy for this condition is still a matter of debate. The aim of this study was to analyse the incidence, clinical presentation, treatment, and possible late recurrences of cervical artery dissections.

The AIUM Practice Parameter for the Performance of an Ultrasound Examination of the Extracranial Cerebrovascular System.

The AIUM Practice Parameter for the Performance of an Ultrasound Examination of the Extracranial Cerebrovascular System.