Young Male with Bilateral ICA Dissection: Beyond CADISS Trial

V. Bhatia, C. Jain, S. Ray, J. Kumar
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Abstract

Objective: To report a case of young male with stroke and bilateral internal carotid artery (ICA) dissection. Background: Cervical Artery Dissection in Stroke Study trial has provided some insight on management of patients with ICA dissection. However, there is a need to modify the management strategies as per specific clinical scenario. Design/Methods: Case report and literature review. Results: A 45-year-old male presented with 1 month old history of acute onset numbness of right half of the body with slurring of speech. Computed tomography angiography showed complete occlusion of left cervical ICA just beyond origin with presence of fusiform dilatation and spiral flap in right extracranial cervical ICA. The patient was started on antiplatelets and taken for endovascular procedure using 2-mesh-based carotid stents. Patient was discharged after 3 days on antiplatelet therapy. At 1-year follow-up, there were no fresh symptoms. Conclusion: This case emphasizes the role of successful endovascular management of carotid dissection in a young male. These clinical situations may not be fully represented in trials, and a case-based approach is required.
年轻男性双侧ICA夹层:超越CADISS试验
目的:报告一例年轻男性脑卒中合并双侧颈内动脉夹层。背景:脑卒中颈动脉夹层研究试验为ICA夹层患者的治疗提供了一些见解。然而,有必要根据具体的临床情况修改管理策略。设计/方法:病例报告和文献回顾。结果:男性,45岁,1个月前出现右半身体急性麻木伴口齿不清的病史。ct血管造影显示左侧颈内卡完全闭塞,右侧颅外颈内卡存在梭状扩张和螺旋瓣。患者开始使用抗血小板药物,并使用2孔颈动脉支架进行血管内手术。患者经抗血小板治疗3天后出院。随访1年,无新发症状。结论:这个病例强调了成功的血管内治疗在年轻男性颈动脉夹层中的作用。这些临床情况可能无法在试验中得到充分体现,因此需要采用基于病例的方法。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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