[Spontaneous dissection of the internal carotid artery. A report of two cases].
BACKGROUND
Dissection of the internal carotid artery is a condition with a broad clinical spectrum. In absence of the classical triad of cervical pain, oculosympathetic ipsilateral paralysis and ischemic cerebral symptoms a considerable index of clinical suspicion is necessary to make a diagnosis. It is therefore considered to be probably underdiagnosed. The development of new techniques for neurovascular investigation, particularly ultrasound and magnetic angioresonance have improved the possibilities of diagnosis.


METHODS
In this paper we describe two cases of dissection of the internal carotid artery representing different clinical findings in the same condition. One patient presented with unilateral paralysis of the XI, X and XII cranial nerves and the other with transient ischemic cerebral accidents. In both cases the provisional diagnosis was made in function of the duplex findings of the supra-aortic trunks and confirmed by magnetic angioresonance studies. Both patients made satisfactory progress with complete recanalization of the vessels and no recurrence of symptoms after several months of follow-up.


CONCLUSIONS
We discuss the different clinical characteristics and findings of the neurovascular examinations.
García-Escrig
M
M
Unidad de Neurología, Hospital de Sagunto, España. mgarciae@meditex.es
Pajarón
E
E
Ponz
A
A
Catalá
J
J
Jordán
Y
Y
D001921:Brain / Q000098:blood supply; D020215:Carotid Artery, Internal, Dissection / Q000150:complications / Q000175:diagnosis*; D003391:Cranial Nerves / Q000503:physiopathology; D003937:Diagnosis, Differential; D006801:Humans; D002546:Ischemic Attack, Transient / Q000175:diagnosis* / Q000209:etiology; D018810:Magnetic Resonance Angiography; D008297:Male; D008875:Middle Aged; D010243:Paralysis / Q000175:diagnosis / Q000503:physiopathology; D014832:Voice Disorders / Q000175:diagnosis / Q000209:etiology
Disección espontánea de la arteria carótida interna. Presentación de dos casos.