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carotid dissection

P X Kuan, P W Tan, A T Jobli, A R Norsila
INTRODUCTION: Differences in systolic blood pressure reading between arms are common but could signal trouble if the discrepancy is significant. Early detection of aortic dissection could invariably determine patient's survivability. Hence, a high index of suspicion with prompt diagnostic imaging is vital for accurate diagnosis. CASE PRESENTATION: A previously healthy 35-year-old lady was referred from district hospital for hypertensive cardiomyopathy complicated by acute pulmonary oedema...
August 2016: Medical Journal of Malaysia
Yu-Dong Ma, Varadharajan Thiyagarajan, May-Jywan Tsai, Sheng-I Lue, Yi-Chen Chia, Song-Kun Shyue, Ching-Feng Weng
Migration of vascular smooth muscle cells (VSMCs) contributes to intimal hyperplasia and other vascular diseases. Caveolin-1 (Cav-1) has been recognized as a proliferative inhibitor of VSMCs and is likely to be an important regulator of VSMC migration. The underlying mechanism of pyrogallol on the VSMC migration is not fully understood. This study attempted to dissect the role of Cav-1 and matrix metalloproteinase (MMP) in VSMC migration and to investigate the effect of pyrogallol on VSMC mobility during carotid artery ligation mice...
October 15, 2016: Environmental Toxicology and Pharmacology
Takahiro Wakasaki, Hirofumi Omori, Shintaro Sueyoshi, Fumihide Rikimaru, Satoshi Toh, Kenichi Taguchi, Yuichiro Higaki, Masaru Morita, Muneyuki Masuda
BACKGROUND: Advanced head and neck squamous cell carcinomas frequently develop distant metastases to limited organs, including the lungs, bone, mediastinal lymph nodes, brain, and liver. Peritoneal carcinomatosis as an initial distant metastasis from hypopharyngeal squamous cell carcinoma is quite rare. CASE PRESENTATION: A 75-year-old man diagnosed with hypopharyngeal squamous cell carcinoma and his clinical stage was determined as T2N2cM0. Notably, the right retropharyngeal lymph node surrounded more than half of the right internal carotid artery...
October 18, 2016: World Journal of Surgical Oncology
Rongjie Zhang, Jian Zhou, Jiaxuan Feng, Zhiqing Zhao, Junjun Liu, Zhenjiang Li, Rui Feng, Zaiping Jing
BACKGROUND: How to choose the proximal landing zone in endovascular interventions for a patient with a patent retrograde false lumen in dissection of the ascending aorta and aortic arch remains unclear. This study sought to report the safety and efficiency of inducing thrombosis of the retrograde false lumen to enhance a proximal landing zone to treat retrograde type A aortic dissection. METHODS: This study included 9 patients with retrograde type A aortic dissection treated with a 2-stage operation strategy between January 2015 and January 2016...
September 22, 2016: Journal of Thoracic and Cardiovascular Surgery
Manoj Kumar Agarwala, Azeez Asad, Naveen Gummadi, Sundar Chidambaram, J Venkateswaralu
Carotid artery dissection (CAD) is a frequent cause of stroke, accounting for up to 25% of all ischemic strokes in young and middle-aged patients.(1,2) It may be traumatic or spontaneous, with multi-factorial etiology. A tear in the arterial wall causes intrusion of blood within its layers, producing intra-luminal stenosis, or aneurysmal dilatation.(3) Thrombo-embolism arising from this anatomic disruption has been postulated as the essential stroke mechanism in CAD.(4) Bilateral internal carotid artery dissection (ICAD) has been rarely reported...
September 2016: Indian Heart Journal
Jennifer Shin Zank, Rani Singh, Michele Carney
Vigorous coughing leading to internal carotid artery dissection has been described in the adult literature but has not been reported in the pediatric population. We describe an 8-year-old right-handed girl who had a 1-week history of increased work of breathing and vigorous coughing. She initially presented to her pediatrician's office for her respiratory symptoms which improved with steroid therapy and albuterol treatments. However, she developed evolving left-sided motor weakness over the course of 2 days and presented to our pediatric emergency department where she was found to have an ischemic stroke in the right corona radiata with a right internal carotid artery dissection...
October 2016: Pediatric Emergency Care
Lucy C Thomas, Lesley Ann Hall, John R Attia, Elizabeth G Holliday, Hugh S Markus, Christopher R Levi
BACKGROUND: Cervical artery dissection (CAD) is a leading cause of stroke among middle-aged adults, but the etiology is unclear. Some reports of seasonal variation in CAD incidence have been suggested but may reflect extreme climatic conditions. Seasonal variation may implicate more transient seasonal causes such as proinflammatory or hypercoagulable states. This study aimed to assess whether CAD incidence varied with season between UK and Australian sites. Also, this study aimed to determine whether there was a different pattern of seasonal variation between arteries (carotid and vertebral) and any association between CAD incidence and clinical factors...
October 10, 2016: Journal of Stroke and Cerebrovascular Diseases: the Official Journal of National Stroke Association
J Stephen Huff, Everett W Austin
Understanding the anatomy and physiology of the eye, the orbit, and the central connections is key to understanding neuro-ophthalmologic emergencies. Anisocoria is an important sign that requires a systematic approach to avoid misdiagnosis of serious conditions, including carotid dissection (miosis) and aneurysmal third nerve palsy (mydriasis). Ptosis may be a sign of either Horner syndrome or third nerve palsy. An explanation should be pursued for diplopia since the differential diagnosis ranges from the trivial to life-threatening causes...
November 2016: Emergency Medicine Clinics of North America
Eduardo Murias Quintana, Pedro Vega Valdés, Edison Morales Deza, Alberto Gil Garcia, Hugo Cuellar Saenz, Alba L Salgado Bernal, María Cadenas Rodríguez, Lorena Benavente Fernández, Montserrat González Delgado, Nuria Riesco Pérez, Davinia Larrosa Campo, Sergio Calleja Puerta
OBJECTIVE: The purpose of this study is to demonstrate our experience in endovascular reconstruction of carotid dissections using the Wingspan Stent System™ (Boston Scientific, Natick, MA, USA), a device we use because of its high radial force and its navigation in extreme curves. METHODS: We treated 11 consecutive patients with acute ischemic stroke due to carotid dissection with the Wingspan stent, in the cervical carotid artery. RESULTS: Functional evaluation revealed that 10 of the 11 patients were independent at 3 months post surgery and that the 11 stents used were found to be patent at the 6-month follow-up digital subtraction angiography (DSA)...
October 13, 2016: Interventional Neuroradiology
Nari Choi, Jee-Eun Yoon, Byoung-Won Park, Won-Ho Chang, Hyun-Jo Kim, Kyung Bok Lee
We report a case of aortic dissection masquerading as acute ischemic stroke followed by intravenous thrombolysis. A 59-year-old man presented with dizziness. After examination, the patient had a seizure with bilateral Babinski signs. Soon after identifying multiple acute infarctions in both hemispheres on diffusion-weighted brain magnetic resonance (MR) imaging, tissue plasminogen activator (t-PA) was administered. Both common carotid arteries were invisible on MR angiography, and subsequent chest computed tomography revealed an aortic dissection...
October 2016: Korean Journal of Thoracic and Cardiovascular Surgery
Vikas Acharya, Suresh Chandrasekaran, Sujit Nair
INTRODUCTION: The authors present an interesting case of a 19-year-old male who presented as a polytrauma patient following a fall from a height. PRESENTATION OF CASE: He was initially managed on the intensive care unit with intracranial pressure bolt monitoring after being intubated and sedated and having his other traumatic injuries stabilized. Upon attempting to wean sedation and extubation a repeat CT scan of the head was undertaken and showed a new area suggested of cerebral infarction, this was a new finding...
October 3, 2016: International Journal of Surgery Case Reports
Mathieu Veyrat, Benjamin Verillaud, Philippe Herman, Damien Bresson
BACKGROUND: Endoscopic endonasal approaches (EEA) are an alternative for removing challenging nasopharyngeal or skull base lesions. In some cases, a nasoseptal flap (NSF) is not always available and such complex procedures may lead to carotid arteries exposition and/or dura mater (DM) wide opening. Meticulous carotid coverage and DM reconstruction are crucial for preventing early and delayed complications. METHOD: We propose a step-by-step description of the pedicled temporoparietal fascia flap (TPFF) technique, with a focus on its pitfalls, advantages and limits...
October 7, 2016: Acta Neurochirurgica
Azer Majeed, Nuno Pedro Lobato Ribeiro, Asem Ali, Mohsen Hijazi, Hina Farook
Spontaneous internal carotid artery dissection (sICAD) is an uncommon cause of isolated cranial nerve palsies. Commonly patients present with stroke, headache, facial pain and Horner's syndrome, with upto 16% having cranial nerve palsies. We present the case of a 55-year-old man who presented with hoarseness, dysphagia and tongue swelling, mimicking a tongue base tumor. He was found to have unilateral VIIth, Xth and XIIth nerve palsies with Horner's syndrome. Magnetic resonance imaging showed high signal changes and loss of signal void in right internal carotid artery, later confirmed by Angiography as a dissection with pseudo-aneurysm...
October 2016: Oxford Medical Case Reports
Jiayan Wang, Dandan Yue, Xin Chen, Zhenyu Wei, Wenmei Lu, Danhong Wu
In the present study, a case of acute cerebral infarction with radiation-induced carotid artery dissection is reported. Carotid artery dissection is generally asymptomatic at the early stages. Due to the non-specific clinical manifestations of carotid artery dissection, a detailed inquiry of the past history of a patient has a critical role in making a diagnosis of radiation-induced common carotid artery dissection. Onset of acute ischemic stroke is the predominant manifestation, and for patients with a history of head-and-neck radiotherapy, dissection should be considered...
October 2016: Molecular and Clinical Oncology
Shintaro Sukegawa, Takahiro Kanno, Kengo Kanai, Toshiko Mandai, Akane Shibata, Yuka Takahashi, Yuji Hirata, Yoshihiko Furuki
Carotid artery stenosis is a significant risk factor for stroke. In elderly patients with carotid atherosclerosis and stenosis, it is not unusual for oral, head and neck cancer surgery to be performed. The present study describes a case of stroke that occurred during a neck dissection for the treatment of cervical lymph node metastasis of a left maxillary gingival carcinoma. The patient was an 84-year-old female who was considered to be at high risk of a stroke based on pre-operative head and neck computed tomography scans, which detected severe carotid atherosclerosis and stenosis...
October 2016: Oncology Letters
Soumya Mukherjee, Arun Chandran, Anil Gopinathan, Mani Putharan, Tony Goddard, Paul R Eldridge, Tufail Patankar, Hans-Christean Nahser
OBJECTIVE The goal of this study was to assess the safety and feasibility of PulseRider, a novel endovascular stent, in the treatment of intracranial bifurcation aneurysms with wide necks. The authors present the initial results of the first 10 cases in which the PulseRider device was used. METHODS Patients whose aneurysms were intended to be treated with the PulseRider device at 2 institutions in the United Kingdom were identified prospectively. Patient demographics, procedural details, immediate neurological and clinical status, and immediate angiographic outcomes and 6-month clinical and imaging follow-up were recorded prospectively...
September 30, 2016: Journal of Neurosurgery
Jeffrey Steinberg, Vincent Cheung, Gunjan Goel, J Scott Pannell, Javan Nation, Alexander Khalessi
Although there have been reports of carotid artery pseudoaneurysm formation after adenoidectomy and/or tonsillectomy secondary to iatrogenic injury, there are no case reports of successful endovascular reconstruction of the injured artery in the pediatric population. In most pediatric cases, the internal carotid artery (ICA) is sacrificed. The authors report on a 6-year-old girl who presented with odynophagia, left-sided Horner's syndrome, hematemesis, and severe anemia 6 months after a tonsillectomy. On examination she was found to have a pulsatile mass along the left posterior lateral oropharynx, and imaging demonstrated a dissection of the extracranial left ICA and an associated pseudoaneurysm...
September 30, 2016: Journal of Neurosurgery. Pediatrics
H W Wu, L Sun, D M Li, H Jing, B Xu, C T Wang, L Zhang
Objective: To summarize the short- and mid-term results on endovascular repair of primary retrograde Stanford type A aortic dissection with an entry tear in distal aortic arch or descending aorta. Methods: Between December 2009 and December 2014, 21 male patients of primary retrograde Stanford type A aortic dissection with a mean age of (52±9) years received endovascular repair in Department of Cardiothoracic Surgery, Jinling Hospital. Among the 21 cases, 17 patients were presented as ascending aortic intramural hematoma, 4 patients as active blood flow in false lumen and partial thrombosis, 8 patients as ulcer on descending aorta combined intramural hematoma in descending aorta, and 13 patients as typical dissection changes...
October 1, 2016: Zhonghua Wai Ke za Zhi [Chinese Journal of Surgery]
Fang Huang, Qiang Chen, Qing-Quan Lai, Wen-Han Huang, Hong Wu, Wei-Cheng Li
The purpose of this study was to preoperatively evaluate the value of aortic arch lesions by multidetector computed tomography (MDCT) angiography in type A aortic dissection (AD).From January 2013 to December 2015, we enrolled 42 patients with type A AD who underwent MDCT angiography in our hospital. The institutional database of patients was retrospectively reviewed to identify MDCT angiography examinations for type A AD. Surgical corrections were conducted in all patients to confirm diagnostic accuracy.In this study, the diagnostic accuracy of MDCT angiography was 100% in all 42 patients...
September 2016: Medicine (Baltimore)
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