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Spontaneous Internal Carotid Artery Dissection

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Spontaneous Internal Carotid Artery Dissection

Abstract


Once considered uncommon, spontaneous dissection of the carotid artery is an increasingly recognized cause of stroke, headache, cranial nerve palsy, or ophthalmologic events, especially in young adults. Even in the presence of existing signs and symptoms, the diagnosis can be missed by experienced physicians of all specialties. We report a case of spontaneous internal carotid artery dissection in a 38-year-old woman with a cortical stroke and visual disturbances as initial symptoms. The diagnosis was confirmed by magnetic resonance imaging/angiography and by angiography. Prompt anticoagulation was instituted, and the patient had complete resolution of symptoms. Cervicocephalic arterial dissection should be included in the differential diagnosis of the causes of cerebrovascular events.

Introduction


Spontaneous dissection of the carotid artery is an important cause of visual obscuration, cranial nerve palsy, and stroke in young adults. Early diagnosis of this condition is difficult, even for experienced physicians of all specialties. Information about spontaneous carotid artery dissection in the internal medicine literature or standard internal medicine textbooks is limited. We report a case of spontaneous internal carotid artery dissection with complete resolution of symptoms after prompt anticoagulation therapy.

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