Common carotid artery dissection: A case report and review of the literature

Victor Zach, Svetlana Zhovtis, Kathryn F. Kirchoff-Torres, Jesse M. Weinberger

Research output: Contribution to journalArticle

15 Citations (Scopus)

Abstract

Common carotid artery dissection (CCAD) is a rare and poorly characterized cause of ischemic stroke. We describe a case of multiple cerebral infarcts in a patient with CCAD initially detected by carotid duplex ultrasonography, and review the literature on CCAD. A Medline search from 1960 to the present for cases of CCAD yielded 46 cases. We extracted demographic data, anatomical location, symptoms, neurosonography, neuroradiology, pathological findings, treatment, and outcomes. The mean age of the patients was 48.8 ± 15.8 years (range, 19-89 years). With our patient, our search found 20 cases of spontaneous CCAD, 11 cases of traumatic CCAD, 4 cases of iatrogenic CCAD, and 12 cases of CCAD associated with aortic arch dissection. The most common presenting neurologic symptoms of CCAD were hemiparesis, decreased consciousness, headache/neck pain, aphasia, and monocular field deficit. The most frequently reported neurosonographic findings included a double lumen, mural thrombus, intraluminal hyperechoic/isoechoic lesion, and intimal flap. Most cases of CCAD were subsequently confirmed with conventional angiography, computed tomography angiography, or magnetic resonance angiography. Treatment differed based on etiology; anticoagulation was used most commonly for spontaneous CCAD, and surgical repair was most often done for traumatic and aortic dissection-associated CCAD. Prognosis was generally good; the majority of patients achieved complete clinical recovery, but 3 died. Our findings indicate that carotid Doppler is a widely accessible, rapid, and noninvasive technique for diagnosing CCAD. Our case and literature review further characterizes the diverse etiologies, clinical course, and radiographic features of CCAD.

Original languageEnglish (US)
Pages (from-to)52-60
Number of pages9
JournalJournal of Stroke and Cerebrovascular Diseases
Volume21
Issue number1
DOIs
StatePublished - Jan 2012
Externally publishedYes

Fingerprint

Common Carotid Artery
Dissection
Tunica Intima
Neck Pain
Magnetic Resonance Angiography
Aphasia
Paresis
Neurologic Manifestations
Consciousness
Thoracic Aorta

Keywords

  • angiography
  • carotid duplex
  • cerebral infarct
  • Common carotid artery
  • dissection
  • stroke

ASJC Scopus subject areas

  • Clinical Neurology
  • Surgery
  • Rehabilitation
  • Cardiology and Cardiovascular Medicine

Cite this

Common carotid artery dissection : A case report and review of the literature. / Zach, Victor; Zhovtis, Svetlana; Kirchoff-Torres, Kathryn F.; Weinberger, Jesse M.

In: Journal of Stroke and Cerebrovascular Diseases, Vol. 21, No. 1, 01.2012, p. 52-60.

Research output: Contribution to journalArticle

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