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Query: UMLS:C0018681 (headache)
 56,091 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

We performed simultaneous coronary artery bypass grafting (CABG) and carotid endarterectomy (CE) in 42 patients (average age, 61 years). Twenty-nine patients had preoperative transient ischemic attacks. Carotid arteriography showed stenosis (greater than 70%) in 38 subjects and extensive ulcerated lesions in two, and two emergency patients were not studied. Carotid artery dissection and sternotomy were simultaneously performed and the patients were cannulated for cardiopulmonary bypass (CPB). We undertook CE (22 left and 24 right) using EEG monitoring prior to CPB in all but one patient. The average carotid occlusion time was 25 minutes without a shunt in 23 patients and 5.5 minutes with a shunt in 19 patients. After CE, CABG was performed with an average aortic clamp time of 39 minutes and an average CPB time of 87 minutes. The operative mortality was 5% (2/42). There were no strokes or perioperative myocardial infarctions. Neurologic morbidity consisted of postoperative headache in one patient, transient upper-extremity weakness in two patients, and transient facial weakness in one patient. The average length of postoperative hospitalization was ten days. Currently, patients with symptomatic coronary artery disease and concomitant carotid bruits with positive noninvasive testing and arteriography should have simultaneous repair of these lesions.
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PMID:Coexistent carotid and coronary artery disease. Surgical management. 660 12

Carotid artery dissection is a major cause of cerebral infarction in the young. The extracranial portion of the internal carotid artery is much more frequently involved than the intracranial portion. In up to 20% of cases it is bilateral or associated with vertebral artery dissection. It is mainly characterised by local signs such as headache or facial pain, Horner's syndrome, lower cranial nerve palsies and pulsatile tinnitus, followed a few hours or days later by signs of cerebral or retinal ischemia. Ultrasound investigations show signs of distal stenosis or occlusion, highly suggestive of dissection, but the best diagnostic tool is presently the association of magnetic resonance imaging (MRI) and MR angiography which tend to replace intra-arterial angiography. The prognosis is highly variable: excellent in cases limited to local signs, but very poor leading to death or major sequelae in about 15% of cases. Various treatments have been suggested but no controlled trial has ever been performed in this condition. Heparin in the acute stage followed by warfarin or aspirin for 3 to 6 months is most commonly used.
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PMID:Internal carotid artery dissection: an update. 951 74

Carotid artery dissection has been reported to occur spontaneously and after many types of neck trauma. A case patient is presented who developed a right-sided oculosympathetic palsy and was found to have bilateral carotid artery dissection after she visited her dentist. To the best of our knowledge, this case represents the first report of bilateral carotid dissection following dental work.
Headache
PMID:Bilateral carotid artery dissection after dental work. 1805 55

Postpartum spontaneous cervicocephalic artery dissection is an uncommon, poorly understood condition following pregnancy. We report a case of a 32-year-old woman with no history of trauma, chiropractic manipulation, connective tissue disorder, or previous headache who developed a mild, unilateral headache 7 days after the uneventful delivery of her third child (no general or neuraxial anesthesia was delivered). Seven days latter she presented to our emergency department complaining of recurrent episodes of right-sided headache coupled with a transient episode of sensory deficits in her left lower limb. Brain magnetic resonance imaging disclosed small infarctions in the internal watershed distribution of right internal carotid artery (ICA). Carotid artery dissection was diagnosed using DSA and T1 FAT-SAT sequences for the depiction of intramural hematoma. The patient was placed under oral anticoagulation and remained asymptomatic during a follow-up period of 6 months. The present case report highlights that cervicocephalic artery dissection is a condition that should be looked for in women with persisting or remitting unilateral headache following childbirth.
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PMID:Spontaneous internal carotid artery dissection: an uncommon cause of recurrent postpartum headache. 1945 26

Carotid artery dissection, one of the most common causes of stroke in patients younger than 40 years of age, may develop spontaneously or after trauma. In 85% of cases, central neurological signs such as stroke, transient ischemic attack and amarozis fugax are seen, while headache and cranial nerve paralysis can be the presenting symptoms in the rest of cases. In this case report, a 35-year of age young male patient who had a progressive carotid artery dissection accompanied by complaints of left sided tinnitus and ipsilateral head and neck pain. The patient was admitted to the clinic with the diagnosis of carotid artery dissection and cerebral angiography (CA) was planned. During the CA performed the day after, three stents were placed in the dissection area. Improvement was observed in all complaints of the patient who was followed up in the clinic for 10 days. The patient was discharged in a healthy condition to return after three months for a control.
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PMID:[Progressive carotid artery dissection causing tinnitus and one-sided head and neck pain]. 2176 57

Background Hemicrania continua (HC) -like headaches have been rarely reported as symptomatic headaches, including cases secondary to cervical artery dissection. Case series We present five cases of HC-like headaches following cervical artery dissection, in three cases with specific indomethacin response. In two cases, comorbidity of fibromuscular dysplasia (FMD) was noted. Conclusion Carotid artery dissection may result in an HC-like headache syndrome. A specific response to indomethacin does not rule out dissection as underlying pathology. Screening for extracranial manifestations of FMD should be considered, especially in middle-aged females.
Cephalalgia 2018 02
PMID:Hemicrania continua in carotid artery dissection - symptomatic cases or linked pathophysiology? 2805 33

Eagle syndrome is defined by an elongated styloid process or a calcified stylohyoid ligament that impinges on surrounding structures and causes a variety of symptoms. Classically, Eagle syndrome presents as neck, throat, or ear pain. The vascular variant, stylocarotid syndrome, can present as headache, transient ischemic attack, or stroke. Carotid artery dissection is a rare complication of stylocarotid syndrome. We report a case of stylocarotid syndrome in a 60-year-old man who presented with a right internal carotid artery (ICA) dissection and focal neurological deficits. Computed tomography with three-dimensional reformatting was used in the evaluation of his pathology. His dissecting right ICA was stented with subsequent symptom resolution. Improved recognition of the relationship between an elongated styloid or calcified stylohyoid ligament and symptomatology may lead to optimal etiology recognition and directed treatment.
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PMID:Eagle syndrome: A case report of stylocarotid syndrome with internal carotid artery dissection. 2853 Jan 60

Carotid artery dissection from rupture of the vasa vasorum is under-recognised. We report the case of a 60-year-old woman presenting to our hospital with a 2-week history of right-sided headache, neck pain, unequal pupils and ptosis after being hit by a wave on the beach. She was diagnosed with painful Horner's syndrome. MR angiogram revealed dissection of the right internal carotid artery with an intramural haematoma without an intimal flap. A diagnosis of carotid artery dissection from rupture of the vasa vasorum was made. Initial antithrombotic (aspirin and clexane) were stopped as she was deemed a low stroke risk with no signs of ischaemia on MR brain. Her clinical course was uneventful with resolution of the intramural haematoma seen on repeat MR angiogram.
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PMID:Hit by the wave: a case of painful Horner's and intramural haematoma of the carotid. 3020 43

Carotid artery dissection secondary to cervical blunt trauma is a rare and potentially life-threatening condition that can cause a variety of clinical presentations, including stroke, headache, neck pain, tinnitus, Horner syndrome and cranial neuropathies and is associated with long-term sequelae. We report a case of a 49-year-old industrial vehicles mechanic who was projected to the ground by the explosion of the tire of a heavy truck he was inflating. In the following hours he presented various neurological signs and symptoms and was admitted to the Emergency Department. During hospitalization the patient underwent clinical and instrumental investigations with AngioCT and MR finding of left internal carotid artery dissection in correspondence of its cervical segment and three acute ischemic lesions in the left temporal, parietal and occipital lobes. Medical management was successful and the patient was discharged from the hospital three weeks after the admission but he wasn't able to get back to work due to neurological sequelae. This case report illustrates that traumatic carotid artery dissection, although rare, should be considered in patients who present neurological symptoms after an explosion, can meet the criteria for a work-related injury and may lead to a permanent decrease in the ability to work.
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PMID:Unusual case of traumatic carotid artery dissection occurred during a work-related activity. A case report. 3037 89