Internal carotid artery obstruction derived from persistent arterial wall dissection associated with old trivial trauma.
A 59-year-old man presented with acute onset of visual loss in his right eye. He was treated under a diagnosis of retinal artery thrombosis. Ultrasonography revealed obstruction of the ipsilateral internal carotid artery (ICA). He had no risk factor for stroke and he denied any history of trauma. Follow-up ultrasonography obtained 6 months later showed spontaneous ICA recanalization. Cerebral angiography demonstrated an arterial wall flap suggesting ICA dissection at the craniocervical junction. He then remembered suffering hemicranial headache and Horner's sign of several days' duration after jumping off a stepladder 1 year earlier. The present case is quite unusual in that persistent carotid arterial wall dissection was thought to proceed to ICA obstruction and manifested as retinal ischemia after a long asymptomatic period.
Akiyama
Yasuhiko
Y
Department of Neurosurgery, Kokura Memorial Hospital, Kita-Kyushu, Fukuoka, Japan. yakiyama@shimane-med.ac.jp
Tanaka
Masahito
M
Hayashi
Junya
J
Fujimoto
Motoaki
M
Harada
Kei
K
Nakahara
Ichiro
I
Taniwaki
Yoshinori
Y
D001766:Blindness / Q000209:etiology; D002343:Carotid Artery, Internal / Q000000981:diagnostic imaging* / Q000473:pathology; D020215:Carotid Artery, Internal, Dissection / Q000000981:diagnostic imaging*; D016893:Carotid Stenosis / Q000000981:diagnostic imaging* / Q000473:pathology; D002473:Cell Wall / Q000473:pathology; D006801:Humans; D018810:Magnetic Resonance Angiography; D008297:Male; D008875:Middle Aged; D011859:Radiography; D015356:Retinal Artery Occlusion / Q000150:complications / Q000175:diagnosis*; D018616:Ultrasonography, Doppler, Duplex