Carotid Dissection with Cranial Nerves Palsy
DOI:
https://doi.org/10.24950/rspmi.821Keywords:
Carotid Artery Internal Dissection, Cranial Nerve Diseases, Horner SyndromeAbstract
Internal carotid artery dissection is uncommon and represents
2-2.5% of all strokes in the general population, however
with a higher prevalence in the younger. It can occur
spontaneously or secondary to trauma. Manifestations are
usually cervical and cranial pain, symptoms of cerebral ischemia,
Horner syndrome, as well as cranial nerve palsy in
more than 10% of the cases. The authors describe the case
of a 44-year-old man who presented pain followed by Horner
syndrome, convergent strabismus suggesting 6th nerve
palsy and facial asymmetry characteristic of peripheral facial
palsy after an episode of left cervical pain. There were no
acute ischemic lesions on the cranial computed tomography
and no relevant changes on the doppler ultrasound of the
carotid vessels. The initial suspicion of a left internal carotid
artery dissection was later confirmed by magnetic resonance
angiography.
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References
Bogousslavsky J, Despland PA, Regli F. Spontaneous carotid dissection with acute stroke. Arch Neurol. 1987; 44:137-14.
Giroud M, Fayolle H, Andre N, Dumas R. Incidence of internal carotid artery dissection in the community of Dijon. J Neurol Neurosurg Psychiatry. 1994; 57:1443.
Arnold M, Sturzenegger M. Cervico-cephalic arterial dissections, In: Arnold M, Sturzenegger M, editors. Uncommon Causes of Stroke. 2nd ed. Cambridge: Cambridge University Press; 2008.p. 433-50.
Markus HS, Hayter E, Levi C, Feldman A, Venables G, Norris J, et al. Antiplatelet treatment compared with anticoagulation treatment for cervical artery dissection (CADISS): a randomised trial. Lancet Neurol. 2015; 14: 361–7.
Warlow C, Gijn J, Dennis M, Wardlaw J, Bamford J, Hankey G. Cervical arterial dissection, In: Warlow C, Gijn J, Dennis M, editors. Stroke – Practical Management. 3th ed. Cambridge: Blackwell Publishing; 2008. P. 355-8.
Dziewas R, Konrad C, Dräger B, Evers S, Besselmann M, Lüdemann P, et al. Cervical artery dissection – clinical features, risk factors, therapy and outcome in 126 patients. J Neurol. 2003; 250:1179–84.
Mokri B, Silbert PL, Schievink WI, Piepgras DG. Cranial nerve palsy in spontaneous dissection of the extracranial internal carotid artery. Neurology. 1996; 46:356-9.
Sturzenegger M, Huber P. Cranial nerve palsies in spontaneous carotid artery dissection. J Neurol Neurosurg Psychiatry. 1993; 56:1191-9.
Gout O, Bonnaud I, Weill A, Moulignier A, Quenet J, Moret J, et al. Facial diplegia complicating a bilateral internal carotid artery dissection. Stroke. 1999; 30:681-6.
Naik VD, Shah JV. A rare combination of facial and hypoglossal nerve palsies following post-traumatic internal carotid artery dissection. BMJ Case Rep. 2015; pii: bcr2014209122.
Kogan M, Natarajan SK, Kim N, Sawyer RN, Snyder KV, Siddiqui AH. Third nerve palsy following carotid artery dissection and posterior cerebral artery thrombectomy: Case report and review of the literature. Surg Neurol Int. 2014; 5: 497–500.
Lasjaunias P, Berenstein A. Surgical Neuroangiography. Berlin: Springer- Verlag; 1987.
Brott T, Halperin J, Abbara S, Bacharach J, Barr J, Bush R, et al. Guideline on the. Circulation. 2011; 124:e54-e130.
Engelter S, Dallongeville J, Kloss M, Metso T, Leys D, Brandt T, et al. Thrombolysis in cervical artery dissection - data from the Cervical Artery
Dissection and Ischaemic Stroke Patients (CADISP) database. Eur J Neurol. 2012; 19:1199-206.
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