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Query: UMLS:C0038454 (stroke)
 147,016 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Carotid artery dissection is not uncommon and usually starts at the internal carotid artery. It rarely begins in the common carotid artery. It may cause symptoms of cerebral vascular insufficiency such as stroke and transient ischemic attacks. The case reported here is a 38-year-old man with an acute onset of left hemiparesis 2 hours after drinking three bottles of beer. Computed tomographic scan showed cerebral infarction in the territory of the right middle and anterior cerebral arteries. Ultrasonic imagings showed an intimal flap, starting at the bifurcation of the right common carotid artery, indicative of arterial dissection. Angiography confirmed the diagnosis and the arterial dissection appeared to extend into and terminate at the internal carotid artery.
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PMID:Common carotid artery dissection diagnosed by ultrasonic image: report of a case. 198 80

Nine patients with dissections of the cervical arteries are presented. Dissections cause approximately three per cent of non-haemorrhagic stroke and are usually observed in young and middle-aged patients. Dissections very often give rise to head or neck pain. Carotid artery dissection may lead to lower cranial nerve dysfunction and an incomplete Horner's syndrome in case of subadventitial dissection, and to cerebral ischaemia in case of subintimal spread. Vertebral artery dissection may cause brain stem ischaemia (subintimal dissection) or in rare cases a subarachnoid haemorrhage (subadventitial spread). The history frequently reveals a (trivial) traumatic event. Diagnosis is usually established by angiography or MRI. The prognosis is good and recurrences are rare. Treatment with anticoagulants or acetylsalicylic acid seems recommendable, though scientifically unproven.
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PMID:[Dissection of cervical arteries as a cause of cerebral ischemia or cranial nerve dysfunction]. 221 57

Carotid artery dissection (CAD) is one of the more common causes of stroke in persons younger than 50 years. In this age group and in older persons, CAD is most often associated with trauma. Significant morbidity can be a consequence of CAD, particularly a stroke or other permanent neurologic deficit. Because stroke is the third leading cause of death in the United States, attention has focused in the past decade on understanding the phenomenon of dissection of the carotid artery. This article presents a review of the risk factors associated with CAD, the role of the nurse as a provider of care for these persons, and the approaches to prevent or limit disability related to CAD, the ultimate goal of patient care. Nurses play a crucial role in the detection of CAD and in the prevention of strokes or other neurologic disabilities through recognition of persons at risk, assessment for early signs and symptoms, and implementation of prophylactic measures. Because more than half of persons with CAD have cerebral ischemia, thrombolytic, anticoagulant, and antiplatelet regimens have evolved to limit the development of a thromboembolic event associated with dissection. The administration of these agents, the monitoring for their effectiveness, and the education of patients receiving them are fundamental aspects of care.
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PMID:Carotid artery dissection. 1125 33

This article presents the case of a healthy 46-year-old man who experienced a dissection of the internal carotid artery. The diagnosis of this condition is not usually clear-cut, especially in a young patient with unremarkable medical history, and because of the similarity of symptoms with migraine. Often there is no obvious cause of a cerebral artery dissection, although subtle abnormalities of connective tissue may be present. Anticoagulation is generally used for therapy, but clinical trials are lacking. Carotid artery dissection should be considered as a cause of stroke in young healthy adults.
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PMID:Stroke in a healthy 46-year-old man. 1138 32

Carotid artery dissections (CADs) represent an uncommon clinical condition that should be considered in the differential diagnosis of young individuals presenting with symptoms of stroke. The basic pathological changes in CAD include a disruption in the media or intima of arterial wall, through which the affected vasculature is predisposed to aneurysm or stenosis, and subsequent stroke. Carotid artery dissection may occur spontaneously or result from trauma, an underlying arteriopathic condition, or predisposing risk factors. The heterogeneous clinical presentations of CAD represent significant diagnostic difficulties, which often lead to delays in diagnosis and treatment. Further complicating the clinical picture is the lack of consensus regarding effective treatment modalities. Because of the often-subtle findings present in CAD, the treating physician must have a high index of suspicion to accurately diagnose and manage the condition. We report extracranial internal CAD in a 17-year-old girl leading to multiple infarcts that was successfully managed with initial antiplatelet therapy and subsequent anticoagulation.
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PMID:Trauma-induced extracranial internal carotid artery dissection leading to multiple infarcts in a young girl. 1704 74

Carotid artery dissection is an important cause of stroke in patients under forty years of age. A dissection of the common carotid artery is relatively rare. This condition can easily be overlooked because symptoms may be lacking or may seem trivial. Carotid artery dissection occurs mostly in previously healthy patients. Urgent treatment however, by means of coumarines or antiplatelet agents, is of life-saving importance, because this disease can lead to permanent neurological deficits or even death. We report a case of a 36-year-old patient who was admitted to the intensive care unit with hemi-paralysis and acute abdomen after a period of severe vomiting. A perforated bulbar ulcer was visible on abdominal CT scan. The patient underwent laparoscopic repair of the perforation. CT scan of the brain showed an extensive area of infarction at the region of the left medial cerebral artery. The cause of the infarction was revealed by angio CT of the supra-aortic arteries, showing a floating thrombus and a possible dissection of the left common carotid artery. Under Clopidogrel therapy, the right-sided paralysis partially recovered. Ten days post-admission, an endarterectomy of the left carotid artery was successfully performed. The patient recovered well and was discharged from the ICU 28 days after admission.
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PMID:Dissection of the common carotid artery: a case report. 1949 85

The study comprised 100 ischemic stroke patients of both sexes aged 15-45 years who were treated at the Clinic of Neurology of the Clinical Center of Vojvodina in the period January 2001-September 2004. All study subjects were divided into three age groups: 15-25, 26-35 and 36-45 years. Sex, age and risk factors for cerebrovascular disease were determined in all patients. Diagnostic procedures applied in all patients included brain computed tomography and/or magnetic resonance imaging, routine laboratory tests, Doppler imaging of extra and endocranial blood vessels and coagulation tests. Contrast and/or transesophageal echocardiography, immunological blood assays, magnetic resonance angiography and/or computed tomography angiography and/or conventional angiography, thrombophilia markers, antiphospholipid antibodies and toxicological examination, etc. were performed in selected patients. Non-atherosclerotic arteriopathies were found in 8% of all study subjects, and were the most frequent cause of stroke in the age group 15-25. Carotid artery dissection was the most frequent diagnosis overall, found in 6% of all patients. Fibromuscular dysplasia and systemic vasculitis were diagnosed in one patient each. Moyamoya disease, Takayasu disease, infectious and isolated vasculitis of the CNS were not found in our patients.
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PMID:Non-atherosclerotic arteriopathy as the cause of ischemic stroke among young adults. 2118 Feb 71

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

Carotid artery dissection is a cause of stroke, especially in young and middle-aged patients. A dissection occurs when there is an intimal tear or rupture of the vasa vasorum, leading to an intramural hematoma, which is thought to result from trauma or can occur spontaneously, and is likely multifactorial, involving environmental and intrinsic factors. The clinical diagnosis of carotid artery dissection can be challenging, with common presentations including pain, partial Horner syndrome, cranial nerve palsies, or cerebral ischemia. With the use of noninvasive imaging, including magnetic resonance and computed tomography angiography, the diagnosis of carotid dissection has increased in frequency. Treatment options include thrombolysis, antiplatelet or anticoagulation therapy, endovascular or surgical interventions. The choice of appropriate therapy remains controversial as most carotid dissections heal on their own and there are no randomized trials to compare treatment options.
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PMID:Cervical carotid artery dissection: current review of diagnosis and treatment. 2230 16

In the present study, a case of acute cerebral infarction with radiation-induced carotid artery dissection is reported. Carotid artery dissection is generally asymptomatic at the early stages. Due to the non-specific clinical manifestations of carotid artery dissection, a detailed inquiry of the past history of a patient has a critical role in making a diagnosis of radiation-induced common carotid artery dissection. Onset of acute ischemic stroke is the predominant manifestation, and for patients with a history of head-and-neck radiotherapy, dissection should be considered. The condition may progress rapidly, and result in a poor prognosis. Therefore, a correct early diagnosis and initiation of appropriate therapy may lead to rapid recovery, and influence the overall prognosis.
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PMID:Common carotid artery dissection caused by radiotherapy: A case report. 2769 45


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