title: [Case of spontaneous cervical internal carotid artery dissection with embolic stroke after a job-change].
abstract: A 51 year old male was admitted to our hospital with sudden consciousness disturbance, global aphagia and right hemiparesis. Magnetic resonance imaging (MRI) revealed fresh infarctions in the territory of the left middle cerebral artery, and MR angiography (MRA) showed occlusion of the left carotid artery and the left middle cerebral artery. We started conservative therapy, including antiplatelet drug and blood pressure control. Three days later, cervical MRA revealed hematoma in the intracranial carotid wall of the petrous portion, leading to a diagnosis of spontaneous intracranial carotid artery dissection of the petrous portion. Two weeks after admission, MRA and angiography showed recanalization and pearl and string sign in the left petrous internal carotid artery. After that, the patient's neurological deficit improved, and the dissection also improved. Four months later, MR-angiography revealed an almost normalized condition.
authors.affiliation: Department of Neurosurgery, and Shiraniwa Hospital.
authors.forename: Yu-Ichi
authors.initials: Y
authors.lastname: Aoyama
authors.forename: Shinsuke
authors.initials: S
authors.lastname: Ohta
authors.forename: Saburou
authors.initials: S
authors.lastname: Sakaki
authors.forename: Shigeru
authors.initials: S
authors.lastname: Nishizawa
authors.forename: Toyohisa
authors.initials: T
authors.lastname: Fujita
mesh_terms: D000983:Antipyrine / Q000031:analogs & derivatives / Q000627:therapeutic use; D001120:Arginine / Q000031:analogs & derivatives; D020215:Carotid Artery, Internal, Dissection / Q000175:diagnosis* / Q000188:drug therapy / Q000209:etiology* / Q000473:pathology; D003937:Diagnosis, Differential; D000077553:Edaravone; D006801:Humans; D020244:Infarction, Middle Cerebral Artery / Q000175:diagnosis* / Q000188:drug therapy / Q000209:etiology* / Q000473:pathology; D020766:Intracranial Embolism / Q000150:complications; D018810:Magnetic Resonance Angiography; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D010563:Personnel Turnover; D010875:Pipecolic Acids / Q000627:therapeutic use; D010975:Platelet Aggregation Inhibitors / Q000627:therapeutic use; D013315:Stress, Psychological / Q000150:complications*; D020521:Stroke / Q000150:complications; D013449:Sulfonamides; D016526:Workload / Q000523:psychology*; D017132:Workplace / Q000523:psychology*
chemical_list: D010875:Pipecolic Acids; D010975:Platelet Aggregation Inhibitors; D013449:Sulfonamides; D001120:Arginine; C031942:argatroban; D000077553:Edaravone; D000983:Antipyrine