Recurrent extracranial carotid artery vasospasms: report of 2 cases.
OBJECTIVE
Spontaneous vasospasms of the submandibular internal carotid arteries are rarely observed. They are a highly dynamic process, recur frequently, and can be detected by serial ultrasound examinations.


METHODS
We present 2 cases of recurrent extracranial vasospasms of the internal carotid artery as a cause of stroke. In both cases, arterial dissection was initially suspected, but no intramural hematoma was detected on magnetic resonance imaging. Duplex sonography demonstrated recurrent high-grade stenoses of both internal carotid arteries that resolved spontaneously within hours to days. The vasospasms were treated with calcium antagonists and in 1 patient with oral corticoids.


CONCLUSIONS
Extracranial vasospasms as a cause of stroke might be underestimated. Vasospasms of the internal carotid arteries should be considered in patients with recurring ischemic events in the absence of any other explanation. Antiphlogistic treatment in combination with calcium antagonists might be effective to reduce the frequency of vasospasms.
Janzarik
Wibke G
WG
Department of Neurology, University of Freiburg, Neurocenter, Breisacher Strasse 64, 79106 Freiburg, Germany. janzarik@nz11.ukl.uni-freiburg.de
Ringleb
Peter A
PA
Reinhard
Matthias
M
Rauer
Sebastian
S
D000328:Adult; D002121:Calcium Channel Blockers / Q000627:therapeutic use; D002340:Carotid Artery Diseases / Q000150:complications* / Q000000981:diagnostic imaging / Q000188:drug therapy / Q000503:physiopathology; D002343:Carotid Artery, Internal; D016893:Carotid Stenosis / Q000150:complications / Q000000981:diagnostic imaging / Q000503:physiopathology; D005260:Female; D005938:Glucocorticoids / Q000627:therapeutic use; D006801:Humans; D018810:Magnetic Resonance Angiography; D008297:Male; D008775:Methylprednisolone / Q000627:therapeutic use; D008875:Middle Aged; D012008:Recurrence; D012075:Remission, Spontaneous; D020521:Stroke / Q000209:etiology*; D018616:Ultrasonography, Doppler, Duplex; D020301:Vasospasm, Intracranial / Q000150:complications* / Q000000981:diagnostic imaging / Q000188:drug therapy / Q000503:physiopathology
D002121:Calcium Channel Blockers; D005938:Glucocorticoids; D008775:Methylprednisolone