title: [Dissection of four cerebral arteries after protracted birth].
abstract: A 37-year-old woman suffered from middle cerebral artery infarction secondary to dissection of the left internal carotid artery. Nine days before, a cesarean section had been performed on her after 20 h of unsuccessful labor. Cerebral angiography at admission revealed no further vascular abnormalities. A few days later, however, the patient developed additional dissections of the right internal carotid artery and both vertebral arteries. Pregnancy, childbirth, and a history of rheumatoid arthritis in this patient may have contributed to the dissections; however, due to the unknown etiology of cervical dissections, the pathogenetic contribution of all of these factors is incompletely understood.
authors.affiliation: Neurologische Klinik, Universitätsklinikum Heidelberg.
authors.forename: J
authors.initials: J
authors.lastname: Oehler
authors.forename: Ch
authors.initials: Ch
authors.lastname: Lichy
authors.forename: J
authors.initials: J
authors.lastname: Gandjour
authors.forename: J
authors.initials: J
authors.lastname: Fiebach
authors.forename: A J
authors.initials: AJ
authors.lastname: Grau
mesh_terms: D000328:Adult; D000784:Aortic Dissection / Q000175:diagnosis*; D001037:Aphasia / Q000175:diagnosis; D001172:Arthritis, Rheumatoid / Q000175:diagnosis; D020215:Carotid Artery, Internal, Dissection / Q000175:diagnosis*; D002585:Cesarean Section; D003952:Diagnostic Imaging; D005260:Female; D005500:Follow-Up Studies; D006429:Hemiplegia / Q000175:diagnosis; D006801:Humans; D020244:Infarction, Middle Cerebral Artery / Q000175:diagnosis; D002532:Intracranial Aneurysm / Q000175:diagnosis*; D007744:Obstetric Labor Complications / Q000175:diagnosis*; D011183:Postoperative Complications / Q000175:diagnosis; D011247:Pregnancy; D011644:Puerperal Disorders / Q000175:diagnosis*; D012008:Recurrence; D012307:Risk Factors; D020217:Vertebral Artery Dissection / Q000175:diagnosis
vernacular_title: Vier-Gefäss-Dissektion nach protrahierter Geburt.