Disección carotídea espontánea y secuencial en un paciente con síndrome antifosfolipídico

Introduction

Spontaneous dissection of cervical arteries represents only 2% of all strokes, but represents approximately 10-25% of strokes in youth. Its etiology is sometimes a diagnostic challenge.

Objective

To describe a case of sequential bilateral carotid dissection with a late recurrence suggestive of underlying arteriopathy.

Patients and methods

A 54-year-old woman with acute left carotid dissection with acute/subacute ischemic lesions due to arterial-arterial embolism that progressed as a transient ischemic attack and compressive symptoms with clinical expression of ipsilateral Horner syndrome, which in the study showed a previous right carotid dissection with an organized intraluminal thrombus. She had presented headache and pupillary anisocoria 8 months earlier which were solved spontaneusly. A described extension study was carried out in which an antiphospholipid syndrome was revealed, being confirmed by a history of recurrent abortions.

Conclusions

Sequential dissection with late recurrence seems to be more related to underlying pathologies likewise arteriopathy or to systemic diseases such as antiphospholipid syndrome, which is why extensive screening for underlying pathology is required.