Upper cranial nerve palsy resulting from spontaneous carotid dissection

Wessels, Tiemo; Röttger, Carina; Kaps, Manfred; Traupe, Horst; Stolz, Erwin

doi:10.1007/s00415-005-0673-7

Cited by 9 publications

(5 citation statements)

References 16 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…Local symptoms, especially lower cranial nerves palsies, are traditionally explained by the compressive effect of an enlarged carotid artery, and therefore, thought to be associated with DAs [16]. In addition, hypoperfusion due to an impaired or compressed vasa nervorum has been discussed as a potential cause of cranial nerve palsies [17]. In the present study, we found similar rates for Horner's syndrome, cranial nerve palsies, and tinnitus when comparing the groups.…”

Section: Symptomssupporting

confidence: 76%

“…However, the lower rate of ischemic stroke after correction for the degree of stenosis in our secondary analysis (Figure 4) contradicts this reasoning. One could postulate that we are dealing with two facets of the same pathophysiological process and that mechanical factors, namely the characteristics and the size of the initial tear, the shape of the intramural hematoma, an increased vessel caliber, or different pathomechanisms, such as the primary rupture of the vasa vasorum, may be the main difference between aneurysmal and non-aneurysmal SCADs, leading to the lower rate of ischemic strokes we have seen in our data [17].…”

Section: Symptomsmentioning

confidence: 84%

See 1 more Smart Citation

Comparison of Aneurysmal and Non-Aneurysmal Spontaneous Cervical Artery Dissections in a Large Multicenter Cohort

Steinsiepe,

Sarikaya,

Mordasini

et al. 2024

CTN

View full text Add to dashboard Cite

Dissecting aneurysms in patients with spontaneous cervical artery dissections have, so far, been reported as “benign”, but more specific information is scarce. We aimed to elucidate (1) vascular risk factors, (2) local and ischemic symptoms, and (3) long-term prognosis compared to non-aneurysmal dissections. This case–control study included consecutive patients with spontaneous cervical artery dissection from three university hospitals in Switzerland and France, evaluated at baseline and at 3 months. In addition, further follow-ups were performed at the discretion of the treating physician. Dissecting aneurysms were diagnosed with duplex sonography, magnetic resonance angiography, and/or digital subtraction angiography. Of 1012 patients, 151 (14.9%) presented with 167 dissecting aneurysms at baseline (n = 103) or follow-up (n = 64). The median follow-up was 24.9 months (IQR: 6.8–60.8). Compared to patients without a dissecting aneurysm there were no significant differences in the vascular risk factors or local symptoms (91.4 vs. 89.8%). Ischemic strokes at baseline were less common (29.1% vs. 54.4%; OR: 0.41; 95% CI: 0.28–0.60) in patients with a dissecting aneurysm, even after correction for the degree of stenosis of the dissected arteries (OR: 0.53; 95% CI: 0.34–0.81). Patients with a dissecting aneurysm more often had a favorable clinical outcome (modified Rankin Scale Score of 0–1) at 3 months (80.6% vs. 54.5%). There was no significant difference in recurrent cerebrovascular events at 3 months or overall. The lower rate of ischemic strokes at baseline may reflect a different pathogenic mechanism, such as a smaller initial tear in the vessel wall or an increased vessel caliber from an early or primary intramural hematoma with a different shape.

show abstract

Section: Symptomssupporting

confidence: 76%

Section: Symptomsmentioning

confidence: 84%

Comparison of Aneurysmal and Non-Aneurysmal Spontaneous Cervical Artery Dissections in a Large Multicenter Cohort

Steinsiepe,

Sarikaya,

Mordasini

et al. 2024

CTN

View full text Add to dashboard Cite

show abstract

“…Cervical artery dissection (CeAD) causes ischemic stroke, Horner syndrome and/or multiple cranial nerve palsies, usually involving the lower cranial nerves [ 3 ]. However, there has been several reports of upper cranial nerve palsy resulting from spontaneous internal carotid artery (ICA) dissections [ 4 ].…”

Section: Introductionmentioning

confidence: 99%

A case report of multiple cervical artery dissection after peripheral type facial palsy and use of steroids

et al. 2018

View full text Add to dashboard Cite

BackgroundCervical artery dissection is one of the most important causes of ischemic stroke in young age patients. However, multiple cervical artery dissection simultaneously involving the anterior and posterior circulation is uncommon. Here, we would like to report a case of a patient with bilateral vertebral artery (VA) and internal carotid artery dissection (ICA) after a use of systemic steroid due to peripheral facial palsy.Case presentationA 44-year-old man with hypertension visited emergency department due to recurrent vertigo. He was receiving methyl prednisolone for two weeks for the treatment of right peripheral type facial palsy which occurred after retro-orbital headache. Neurologic examination revealed severe ataxia at left side. Sensory for pain and temperature was declined in the right arm and leg. Diffusion-weighted image showed an acute ischemic lesion at the whole territory of posterior-inferior cerebellar artery. Severe stenosis was observed from bilateral VAs and ICAs on conventional magnetic resonance angiography. Intramural hematoma and intimal flap was observed from the high-resolution MRI.ConclusionsPeripheral type facial palsy is an unusual presentation of carotid dissection. Steroids aggravate arterial dissection by increasing blood pressure and blood vessel fragility by its negative effect on connective tissue strength. Use of steroid in patients with peripheral type facial palsy with severe headache may need caution.

show abstract

“…(1) Eine Druckparese durch die lokale Raumforderung des H ä matoms, vor allem, wenn sich das intramurale H ä matom in den Sinus cavernosus ausbreitet [53,55,56] . 2Eine isch ä mische L ä sion der Hirnnerven durch Verschluss der Vasa nervorum als Folge der Karotisdissektion [57] . Ein pulssynchroner Tinnitus, der wahrscheinlich durch fortgeleitete Turbulenzen des Blutstroms an der ACI Stenose entsteht, wird in 16 -27 % der F ä lle berichtet und kann auch ein Zeichen einer beginnenden Rekanalisation einer initial verschlossenen Arterie sein [49,52,58] .…”

Section: ▼ Klinische Befunde Spontane Und Traumatische Dissektionenunclassified

Dissektionen der hirnversorgenden Arterien, spontan und traumatisch, extra – und intrakraniell – Aktuelle Konzepte zur Pathophysiologie, Diagnostik und Therapie

Dittrich¹,

Ritter²,

Naßenstein³

et al. 2011

Klin Neurophysiol

View full text Add to dashboard Cite

Upper cranial nerve palsy resulting from spontaneous carotid dissection

Cited by 9 publications

References 16 publications

Comparison of Aneurysmal and Non-Aneurysmal Spontaneous Cervical Artery Dissections in a Large Multicenter Cohort

Comparison of Aneurysmal and Non-Aneurysmal Spontaneous Cervical Artery Dissections in a Large Multicenter Cohort

A case report of multiple cervical artery dissection after peripheral type facial palsy and use of steroids

Dissektionen der hirnversorgenden Arterien, spontan und traumatisch, extra – und intrakraniell – Aktuelle Konzepte zur Pathophysiologie, Diagnostik und Therapie

Contact Info

Product

Resources

About