title: Rare case of bilateral traumatic internal carotid artery dissection.
abstract: A 55-year-old man was working in a trench when the wall collapsed in on him, pinning him to the wall. On arrival in the emergency department the patient began reporting of right-sided headache. Neurological examination revealed left-sided reduced sensation with weakness. Whole-body CT scan showed right-sided flail chest and bilateral haemothorax as well as loss of flow and thinning of the distal right internal carotid artery (ICA) and loss of grey white matter differentiation in keeping with traumatic ICA dissection with a right middle cerebral artery (MCA) infarct. He was started on aspirin 300 mg once daily. 3 days postadmission the patient experienced worsening of vision and expressive dysphasia. CT angiogram showed bilateral ICA dissections extending from C2 to the skull base. The patient was managed conservatively in the stroke unit for infarction and was discharged home for follow-up in stroke clinic.
authors.affiliation: King's College Hospital, London, UK.
authors.forename: Joanne May
authors.identifier: http://orcid.org/0000-0002-4812-5270
authors.initials: JM
authors.lastname: Jenkins
authors.affiliation: King's College Hospital, London, UK.
authors.forename: Joel
authors.initials: J
authors.lastname: Norton
authors.affiliation: Department of Neuroradiology, King's College Hospital, London, UK.
authors.forename: Timothy
authors.initials: T
authors.lastname: Hampton
authors.affiliation: Department of Neuroradiology, King's College Hospital, London, UK.
authors.forename: Robert
authors.initials: R
authors.lastname: Weeks
mesh_terms: D001241:Aspirin / Q000627:therapeutic use; D020215:Carotid Artery, Internal, Dissection / Q000175:diagnosis* / Q000188:drug therapy / Q000503:physiopathology; D000077144:Clopidogrel; D006261:Headache / Q000209:etiology / Q000503:physiopathology*; D006801:Humans; D020243:Infarction, Anterior Cerebral Artery / Q000175:diagnosis* / Q000188:drug therapy / Q000503:physiopathology; D008297:Male; D008875:Middle Aged; D009460:Neurologic Examination; D015840:Oculomotor Nerve Diseases / Q000175:diagnosis / Q000209:etiology / Q000503:physiopathology*; D010975:Platelet Aggregation Inhibitors / Q000627:therapeutic use; D013988:Ticlopidine / Q000031:analogs & derivatives / Q000627:therapeutic use; D014057:Tomography, X-Ray Computed; D016896:Treatment Outcome; D051598:Whole Body Imaging
chemical_list: D010975:Platelet Aggregation Inhibitors; D000077144:Clopidogrel; D013988:Ticlopidine; D001241:Aspirin