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Ischemic Stroke Secondary to Dissection of the Internal Carotid Artery: A Case Report and a Brief Review

Case Reports in Clinical Medicine 2022年第8期11卷 313-320页

作者： César Hayashi-Mercado Reynaldo Ramírez Chacón Leonardo Ramírez Iñ iguez Carlos Humberto Rodríguez Gómez Abelardo Alexander Aguilar West Natsuo Hayashi-Mercado The American British Cowdray Medical Center Mexico City México Hospital Regional de Pemex Villahermosa México Centro de Especialidades Medicas Dr. Julián Manzur Oca&#241 a ISSET Tabasco City México ecodiagnostica Managua Nicaragua UABC Tijuana México

Background: Internal carotid artery (ICA) dissections generally occur when a tear occurs in the intima-media layer, either of traumatic or spontaneous origin. In this scenario, multifocal cerebral thrombosis may be a clear consequence of untreated ICA dissection. The incidence of internal carotid artery dissection in the US is estimated to be 1.72 per 100,000 population per year. Objective: To make a brief review of the literature and to explain, through a clinical case, the scenario of multiple ischemic cerebrovascular events is associated with the dissection of the internal carotid artery, in a young patient with no relevant history. Presentation of the Case: A 46-year-old female patient, with no significant history, who came to the emergency service presenting loss of strength in the right pelvic limb, disordered language, and difficulty walking for 3 hours, in the neurological examination evidence of decreased tendon reflexes and loss of strength of the right side of the body. Imaging studies show compromise of the M2 and M3 segments of the left middle cerebral artery, as well as multiple areas of associated ischemia in this hemisphere. Additional studies identify concomitant left ICA dissection. Based on the findings, it was decided to perform a thrombectomy of the affected area, as well as subsequent placement of a stent in the area of dissection. In the control angioTC study, revascularization of the M2 and M3 segments was observed, and in the follow-up of the patient, complete recovery of the symptoms was observed, with muscle strength, tendon reflexes, and preserved language functions. Conclusions: The ischemic cerebrovascular event is a frequent pathological entity in the emergency service;in the scenario of a young patient as mentioned above, it is important to take into consideration the different causes of this pathology. We are obliged to familiarize ourselves with the different imaging modalities for an adequate diagnostic approach, as well as the tre

关键词： Ischemic Stroke Dissection Internal Carotid Artery

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