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Query: UMLS:C0007859 (neck pain)
 3,931 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

A case of dissecting aneurysm of the cervical internal carotid artery due to rare mechanism by non-penetrating injury is described. A 45-year-old right-handed man had complaints of the right lateral neck pain during exercise of KENDO wearing a tight headneck protector. Following sudden dysarthria and left hemiplegia, he developed loss of consciousness and generalized convulsion. Five hours after admission, he became alert and had no neurological deficits. Four days after these episodes, he loss visual acuity of the right eye, and a few days later he showed left hemiplegia, hypotension, hypersomnia and right-sides Horner's syndrome. Right retrograde brachial angiography revealed so-called "string sign" in the right extracranial internal carotid artery and delayed circulation in the right cerebral hemisphere. He was diagnosed as having traumatic dissecting aneurysm due to blunt (rubbing) injury. He was treated with STA-MCA anastomosis 3 weeks after the accident. Usually, carotid dissecting aneurysm due to blunt injury is produced by hyperextension and contralateral rotation of the neck or direct blow to the neck, but our case shows a possible mechanism of rubbing injury such as simple anteroposterior flexion under tight neck fixation.
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PMID:[Carotid dissecting aneurysm due to blunt (rubbing) injury of the Kendo protector]. 395 67

Two cases of the spontaneous dissecting aneurysm (SDA) of the cervical carotid artery (ICA) were reported. Case 1: A 36 years old man was admitted with a sudden onset of right hemiparesis, aphasia and a one-week history of headache and neck pain. Serological examinations were normal. Angiography showed a severe stenosis with two intimal flaps of the left cervical ICA. Four weeks later, left STA-MCA anastomosis was performed. After six weeks from the onset, re-angiography showed the resolution of the left cervical ICA stenosis. Case 2: A 26 years old man experienced the transient monoocular blindness a week before admission. He was admitted with a sudden onset of right hemiparesis and aphasia. Serological examinations were normal. Angiography showed a postsinus tapering occlusion of the left cervical ICA. Four weeks later, left STA-MCA anastmosis was performed. After the operation, left hemiparesis improved remarkably. After two weeks from the operation, re-angiography showed the complete resolution of the left cervical ICA stenosis. As the differential diagnoses, spasm, arteritis, embolism and thrombosis with atherosclerosis were listed. But from the reason reported, we diagnosed the two cases as the resolution of the SDA of the ICA. From the previous literature, 129 cases of SDA of the ICA were reviewed and discussed about the symptom, angiographic findings and treatment. Some specific findings (high frequency of resolution, 87%, etc.) were found. SDA of the ICA occurs in the non-atherosclerotic age and causes the ischemic brain damage. SDA of the ICA should be paid more attention and will probably be identified more frequently.
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PMID:[Spontaneous dissecting aneurysm of the cervical internal carotid artery. Report of 2 cases and review of literature]. 652 29

We report a patient with spontaneous cervical internal carotid artery (ICA) dissection. A 46-year-old woman had experienced left neck pain for 10 days. One month later, she was admitted because of the sudden onset of right hemiparesis and left amaurosis, which lasted for 30 minutes. On hospital day 3, the patient experienced the sudden onset of right hemiparesis and total aphasia, which lasted for two weeks. A CT scan failed to reveal any abnormal findings. Cerebral angiograms showed irregular narrowing of the left internal carotid artery distal to the carotid sinus and extending to the base of the skull ("string sign"). Magnetic resonance imaging (MRI) revealed a high signal intensity crescent-shaped mass expanding the wall of the left ICA and narrowing its lumen. SPECT scans showed decreased cerebral blood flow in the left hemisphere. When the symptoms progressed despite-conservative therapy, surgery was performed (STA-MCA anastomosis). Many patients who develop spontaneous ICA dissection show recovery to normal arterial caliber angiographically 1 to 3 months after the onset. Thus, careful monitoring of the clinical course is important and in cases of impending stroke, surgery should be performed immediately.
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PMID:[A case of spontaneous cervical carotid artery dissection]. 766 30