A case series of 22 patients with internal carotid artery dissection

Abstract

The aim of this study was to analyze the spectrum of clinical presentations of internal carotid artery dissection. Twenty-two patients with internal carotid artery dissection, mean age 39.02, were evaluated over the past ten years. Magnetic resonance imaging and magnetic resonance angiography were used to establish the diagnosis. Facial and neck pain and Horner's syndrome were the only presenting symptoms in 4 patients (without brain infarction); facial pain, Horner's syndrome and contralateral sensorimotor deficit in 6; headache and contralateral sensorimotor deficit in 2; contralateral sensorimotor deficit with or without speech impairment in 10. Internal carotid artery dissection was triggered by a trauma in 7, whereas it was spontaneous in 15. Magnetic resonance imaging revealed infarction in 18 patients. A good outcome (modified Rankin score 0-2) was seen in 20 patients. The spectrum of clinical presentations of internal carotid artery dissection is variable. Internal carotid artery dissection is not necessarily accompanied by infarction on magnetic resonance imaging.

Antiplatelets versus Anticoagulants for the Treatment of Cervical Artery Dissection: Bayesian Meta-Analysis

“…None of the included studies reported blinding of investigators responsible for the adjudication of clinical events. For 16 studies, we were able to reconfirm with investigators that outcome data included in our analysis were complete [18], [19], [37], [44], [47], [49]–[55], [57]–[60].…”

“…The median number of patients per study was 21 (range, 2 to 315), with 527 (26%) patients receiving antiplatelets and 1464 (74%) receiving anticoagulants. Twenty-four studies reported outcomes for 1039 patients with internal carotid artery dissection [18], [27]–[33], [35], [37]–[40], [45], [47], [49]–[51], [54]–[58], [60]. Fifteen studies reported outcomes for 532 patients with vertebral artery dissection [18], [34], [36], [42]–[44], [46], [49]–[52], [54], [55], [58], [59].…”

“…Prospective design was reported in 10 studies (27%) including 874 patients [18], [44], [45], [48], [50], [52], [53], [57], [59], [61], and recruitment of consecutive patients in 19 studies (51%) with 1673 patients [18], [19], [31], [32], [34], [44]–[50], [52]–[55], [57]–[59]. Nineteen studies (51%) with a total of 1029 patients included all eligible patients in the analysis [18], [19], [27], [29], [30], [37], [38], [40]–[42], [45], [47], [48], [50], [53], [56], [57], [59], [60]. Twenty-nine studies (78%) including 1125 patients satisfied our criteria of balanced group sizes [18], [27]–[31], [33], [35]–[48], [50], [52]–[57], [61], and eight studies including 1146 patients were considered large [18], [40], [48], [49], [52], [53], [57], [61].…”

“…Thirty-six studies contributed to the analysis of the primary composite outcome of ischaemic stroke, intracranial haemorrhage or death [18], [19], [27]–[60]. Sixty-one patients experienced the primary composite outcome, 13 of 467 patients with antiplatelets and 48 of 1416 patients with anticoagulants.…”

Neuro-ophthalmology Annual Review

“…The spectrums of clinical presentations of ICA dissection included facial pain, neck pain, and concurrent HS in 4 patients; facial pain, HS, and contralateral sensorimotor deficit in 6; headache and contralateral sensorimotor deficit in 2; and contralateral sensorimotor deficit with or without speech impairment in 10. 93 Nizam et al 94 reported a left, pupil-involving oculomotor palsy as a rare presenting sign of left ICA dissection.…”