Emergency department presentation of bilateral carotid artery dissections in a postpartum patient

Abisaab, Josyann; Nevadunsky, Nicole S.; Flomenbaum, Neal

doi:10.1016/j.annemergmed.2004.03.031

Cited by 25 publications

(23 citation statements)

References 9 publications

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“…The patient took aspirin 81 mg daily through week 32 of her subsequent pregnancy and delivered a healthy neonate by cesarean section with no maternal complications. 18 The differential diagnosis of post-partum headache is broad and includes many non-anesthesia related causes. Some causes of headache are benign, but others are potentially serious.…”

Section: Discussionmentioning

confidence: 99%

“…Approximately 80% of cases are complicated by embolic stroke, 15 so rapid diagnosis and anticoagulation are essential to minimize further morbidity and mortality. 16,17 Seven post-partum cases of ICAD have been described in the literature, [18][19][20][21][22] and are summarized in Table 1. Parturition may precipitate or exacerbate ICAD for several reasons.…”

Section: Discussionmentioning

confidence: 99%

“…In addition, expulsive efforts have been proposed as a precipitating factor for those patients who reached the second stage of labor. [18][19][20]22 Finally, the hypercoagulable state of pregnancy contributes to the development thrombosis at the dissection site and subsequent distal embolism.…”

Section: Discussionmentioning

confidence: 99%

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Internal carotid artery dissection: an unusual cause of postpartum headache

Waidelich

Bullough

Mhyre

2008

International Journal of Obstetric Anesthesia

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

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Internal carotid artery dissection: an unusual cause of postpartum headache

Waidelich

Bullough

Mhyre

2008

International Journal of Obstetric Anesthesia

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“…1,[3][4][5][6][7] In addition, 2 patients with basilar artery dissection have been described. 8 We report 6 women with 8 ppCAD (6 VAD and 2 ICAD).…”

Section: Discussionmentioning

confidence: 99%

Postpartum Cervicocephalic Artery Dissection

Arnold

Camus-Jacqmin

Stapf

et al. 2008

Stroke

106

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Background and Purpose-Cervicocephalic artery dissection (CAD) after childbirth is rare. The objective of this study was to determine differences between postpartum and nonpostpartum CAD. Methods-We compared consecutive patients with postpartum CAD with a control group of women with nonpostpartum CAD. Results-Of 245 patients with CAD, 102 women Ͻ50 years (6 with postpartum CAD and 96 with nonpostpartum CAD) were identified. Vascular risk factors and presenting characteristics did not differ significantly between postpartum CAD and nonpostpartum CAD women. By contrast, patients with postpartum CAD had more often coexisting conditions such as reversible cerebral vasoconstriction syndrome (2 of 6 versus 2 of 96; Pϭ0.017), reversible posterior leukoencephalopathy syndrome (2 of 6 versus one of 96; Pϭ0.009), and subarachnoid hemorrhage without signs of intracranial extension of CAD (2 of 6 versus zero of 96; Pϭ0.003). Conclusion-CAD and associated conditions should be looked for in women with unusual headache after childbirth.

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“…Only in two cases could the effect of positive intrathoracal pressure (Valsalva manoeuvre) during labour be dismissed because the childbirth was performed by the planned caesarean's section. In the other two cases, the labour was performed by caesarean's section after an unsuccessful vaginal delivery (5)(6)(7)(8)(9)(10)(11)(12)(13)(14)(15).…”

Section: Discussionmentioning

confidence: 99%

Dynamic Nature of Postpartal Carotid Artery Dissection

Vukicevic¹,

Brkić

Ducic³

et al. 2016

Serbian Journal of Experimental and Clinical Research

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ABBREVIATIONS CCAD -craniocervical carotid artery dissectionCTA -computed tomography angiography DSA -digital selective angiography ICA -internal carotid artery MRA -magnetic resonance angiography АBSTRACT Craniocervical carotid artery dissection (CCAD) is an important cause of stroke in young adults, but it has rarely been reported as a cause of stroke in puerperium.We We report the case of a 27-year-old female with a hi i is s sof migraine who presented with unilateral left hea ad a a atransient episodes of dysphasia and right hemipar r re r sis ys after vaginal delivery. Th e fi rst symptoms started ed ed d ed six after the pro o o ol lo lo lo l ng ng ng ged ed ed ed childbirth. Th e fi rst magnetic c c c c resoangiogra a a a ap p ph p p y revealed ed d ed d d d d d dis is is is issection in the sup p up up upra a ra rac clinoid cavern n n no o ou o s se se se se segm gm g g g en en nt t t t of of of of of t the lef f f ft t t t t In In In nte te ternal al al al a c carotid artery . We fo fo fo o foll ll ll l lo o ow o ed d d d up the pa a a ati t t t en n n nt t t t t for two years and she had stabl l le e e e e co o o our u u se. During this time e e e, , , she had occlusion of the clinoid segment of the left ICA, with caudal extension e ext x x x x ra r r r cranial segment and re eca a analisation one month T T Two w w w m m m m mon onth th ths s la la late ter, r, s she he he h h had ad ad i int ntrac cranial extension with ti i i i ion n n n o o o of f f the left anterior cere e ebr br bra a al artery. During this s s she s su s s s ff ff ff ff ffer e e ed from two stroke e e e es s s s w w wi w w th minimal neurologim mp pa p irme m me me ment nt nt nt t a a and good clinic ic ic ca a al r r r r recovery. The pathop p phy hy hy hy hysi si si iol ol l ol log o og og ogy y y of of of C C CCA CA CA CA AD D D D appears to be multifactoVessel el el w w w wal al a a l injury r l l l elated to the Valsalva manoeuvre durbour, as wel l ll l l l as as as a h h h hemodynamic and hormonal changes of ssel wall related to pre e e egn gn gn gn g an a cy in a patient with a history graine, may be causes of p p po p p stpartum spontaneous crarvical artery dissection in h h

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Emergency department presentation of bilateral carotid artery dissections in a postpartum patient

Cited by 25 publications

References 9 publications

Internal carotid artery dissection: an unusual cause of postpartum headache

Internal carotid artery dissection: an unusual cause of postpartum headache

Postpartum Cervicocephalic Artery Dissection

Dynamic Nature of Postpartal Carotid Artery Dissection

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