title: Bilateral internal carotid artery dissection in the postpartum period.
abstract: BACKGROUND
  Bilateral internal carotid artery dissection is a rare event associated with pregnancy, especially in a patient without any predisposing risk factors.
  
  
  METHODS
  A 34-year-old woman presented with postpartum unilateral weakness, headaches, and blurry vision 14 days after vaginal delivery. Radiologic imaging revealed bilateral cervical internal carotid artery dissections and cerebral infarctions. She was treated with anticoagulation and showed radiographic and clinical improvement.
  
  
  CONCLUSIONS
  The pathophysiology of cervical artery dissection appears multifactorial, with evidence suggesting environmental and genetic contributions. Intimal injury related to the Valsalva maneuver during labor as well as hemodynamic and hormonal changes related to pregnancy are presumed causes of peripartum spontaneous carotid artery dissection. Antithrombotic therapy for at least 3 to 6 months after dissection and follow-up neuroimaging are suggested.
authors.affiliation: From the Albert Einstein College of Medicine and the Departments of Neurology, Obstetrics and Gynecology and Women's Health, and Radiology, Montefiore Medical Center and Albert Einstein College of Medicine, Bronx, New York.
authors.forename: Francis I
authors.initials: FI
authors.lastname: Baffour
authors.forename: Kathryn F
authors.initials: KF
authors.lastname: Kirchoff-Torres
authors.forename: Francine H
authors.initials: FH
authors.lastname: Einstein
authors.forename: Scarlett
authors.initials: S
authors.lastname: Karakash
authors.forename: Todd S
authors.initials: TS
authors.lastname: Miller
mesh_terms: D000328:Adult; D000925:Anticoagulants / Q000627:therapeutic use*; D020215:Carotid Artery, Internal, Dissection / Q000150:complications / Q000000981:diagnostic imaging* / Q000188:drug therapy; D002544:Cerebral Infarction / Q000000981:diagnostic imaging / Q000209:etiology; D005260:Female; D006801:Humans; D011247:Pregnancy; D011644:Puerperal Disorders / Q000000981:diagnostic imaging* / Q000188:drug therapy; D011859:Radiography
chemical_list: D000925:Anticoagulants