title: Spontaneous internal carotid artery dissection: an uncommon cause of recurrent postpartum headache.
abstract: Postpartum spontaneous cervicocephalic artery dissection is an uncommon, poorly understood condition following pregnancy. We report a case of a 32-year-old woman with no history of trauma, chiropractic manipulation, connective tissue disorder, or previous headache who developed a mild, unilateral headache 7 days after the uneventful delivery of her third child (no general or neuraxial anesthesia was delivered). Seven days latter she presented to our emergency department complaining of recurrent episodes of right-sided headache coupled with a transient episode of sensory deficits in her left lower limb. Brain magnetic resonance imaging disclosed small infarctions in the internal watershed distribution of right internal carotid artery (ICA). Carotid artery dissection was diagnosed using DSA and T1 FAT-SAT sequences for the depiction of intramural hematoma. The patient was placed under oral anticoagulation and remained asymptomatic during a follow-up period of 6 months. The present case report highlights that cervicocephalic artery dissection is a condition that should be looked for in women with persisting or remitting unilateral headache following childbirth.
authors.affiliation: Second Department of Neurology, University of Athens School of Medicine, Attikon Hospital, Athens, Greece. lstam@med.uoa.gr
authors.forename: Elefterios
authors.initials: E
authors.lastname: Stamboulis
authors.forename: Georgios
authors.initials: G
authors.lastname: Raptis
authors.forename: Athina
authors.initials: A
authors.lastname: Andrikopoulou
authors.forename: Chrisa
authors.initials: C
authors.lastname: Arvaniti
authors.forename: Elias
authors.initials: E
authors.lastname: Brountzos
authors.forename: Nikos
authors.initials: N
authors.lastname: Oikonomopoulos
authors.forename: Leonidas
authors.initials: L
authors.lastname: Stefanis
authors.forename: Konstantinos
authors.initials: K
authors.lastname: Voumvourakis
mesh_terms: D000328:Adult; D015901:Angiography, Digital Subtraction; D020215:Carotid Artery, Internal, Dissection / Q000150:complications* / Q000000981:diagnostic imaging; D005260:Female; D006261:Headache / Q000000981:diagnostic imaging / Q000209:etiology*; D006801:Humans; D008279:Magnetic Resonance Imaging; D049590:Postpartum Period; D012008:Recurrence