The Case of Left Carotid and Bilateral Vertebral Artery Dissection occured Secondary Minor Trauma

Year 2015, Volume: 5 Issue: 1-Ek, 100 - 81, 28.08.2015

Serpil Yaylaci , Mustafa Serinken Pınar Dikmen

https://doi.org/10.16899/ctd.16747

Abstract

The most common reason of non-aterosclerotic stroke is cervical artery dissection for young patients. They frequently admitted to emergency department with the complaints of headache and pain at neck as a result of minor trauma. Cervical artery dissection may effect both anterior and posterior system and then cause neurological symptoms permanently or temporarily. In this study, the case who was 34 years old, admitted to the hospital with the complaints of headache and pain at neck and diagnosed as dissection of extracranial three artery ; bilateral vertebral artery and left internal carotid artery with the result of radiological examination, has been represented. In terms of emergency physician, investigation of the story of minor or major trauma and the relationship between the pain during first adminstiration and previous pain for young patients who have headache periodically, have an important role to consider the pre-diagnosis of cervical artery dissection and to plan the proper radiological examination

Keywords

Artery dissection, minor trauma, neck pain, emergency department

MİNÖR TRAVMAYA İKİNCİL GELİŞEN SOL KAROTİD VE BİLATERAL VERTEBRAL ARTER DİSEKSİYONU OLGUSU

Abstract

Servikal arter diseksiyonu, genç hastalarda nonateroskelerotik inmenin en sık nedenidir. Bu hastalar sıklıkla baş ve boyun ağrısı şikayeti ile başvururlar. En sık rastlanan neden minör travmadır. Servikal arter diseksiyonu hem anterior hem posterior sistemi etkileyebilir, sonrasında kalıcı veya geçici nörolojik bulgulara neden olabilir. Bu yazıda 34 yaşında, baş ve boyun ağrısı şikayeti ile başvuran ve yapılan radyolojik incelemeler sonucu bilateral vertebral arter ve sol internal karotid arter olmak üzere ekstrakranyal üç damarda diseksiyon saptanan olgu sunulmaktadır. Acil hekimleri açısından periyodik baş ağrısı öyküsü olan genç olgularda hastanın daha önce yaşadığı ağrının başvuru sırasındaki ağrı ile benzer özellikte olup olmadığının ve majör/minör travma öyküsünün sorgulanması; servikal arter diseksiyonu ön tanısının akla gelmesi ve gerekli radyolojik incelemelerin planlanması açısından kritik öneme sahiptir.

Keywords

Arter diseksiyonu, minör travma, boyun ağrısı, acil servis

References

• -
• Kuruvilla A, Bhattacharya P, Rajamani K et al. Factors associated with misdiagnosis of acute stroke in young adults. J Stroke Cerebrovasc Dis 2011; 20(6): 523–7. 2.
• Go S, Worman DJ. Stroke, Transient Ischemic Attack, and Cervical Artery Dissection. In: Tintinalli JE, Stapczynski JS, Ma OJ, Cline DM, Cydulka RK, Meckler GD, eds. Emergency Medicine: A Comprehensive Study Guide. 7th ed. China: McGraw-Hill, 2011: 1122-35. 3.
• Singhal AB, Biller J, Elkind MS et al. Recognition and management of stroke in young adults and adolescents. Neurology. 2013; 81(12): 1089-97. 4.
• Tzourio C, Benslamia L, Guillon B et al. Migraine and the risk of cervical artery dissection: A case-control study. Neurology. 2002; 59(3): 435-7. 5.
• Artto V, Metso TM, Metso AJ et al. Migraine with aura is a risk factor for cervical artery dissection: A case-control study. Cerebrovasc Dis. 2010; 30(1): 36-40 6.
• Chakraponi AL, Zink W, Zimmerman R et al. Bilateral carotid and bilateral vertebral artery dissection following facial massage. Angiology. 2008; 59(6): 761-4. 7.
• Nadgir RN, Loevner LA, Ahmed T, et al. Simultaneous bilateral internal carotid and vertebral artery dissection following chiropractic manipulation: case report and review of the literature. Neuroradiology. 2003;45(5): 311- 4. 8.
• Weintraub MI. Beauty parlor stroke syndrome: report of five cases. JAMA. 1993; 269(16): 2085-6. 9.
• Nwokolo N, Bateman DE. Stroke after a visit to the hairdresser. Lancet 1997; 350(9081): 866.
• The International Classification of Headache Disorders, 3rd edition (beta version). Headache Classification Committee of the International Headache Society (IHS). Cephalalgia. 2013; 33(9): 629-808.
• Debette S. Pathophysiology and risk factors of cervical artery dissection: what have we learnt from large hospital- based cohorts? Curr Opin Neurol. 2014; 27(1): 20-8.
• Metso TM, Tatlisumak T, Debette S et al.; Cervical Artery Dissection and Ischemic Stroke Patients (CADISP) group. Migraine in cervical artery dissection and ischemic stroke patients. Neurology. 2012; 78(16): 1221-8.
• Arnold M, De Marchis GM, Stapf C et al. Triple and quadruple
• Presenting characteristics and long-term outcome. J Neurol Neurosurg Psychiatry. 2009; 80(2): 171-4.
• von Babo M, De Marchis GM, Sarikaya H et al. Differences and similarities between spontaneous dissections of the internal carotid artery and the vertebral artery. Stroke. 2013; 44(6): 1537-42.
• Béjot Y, Aboa-Eboulé C, Debette S et al.; Cervical Artery Dissection and Ischemic Stroke Patients (CADISP) Group. Characteristics and outcomes of patients with multiple cervical artery dissection. Stroke. 2014; 45(1): 37-41.
• Brott TG, Halperin JL, Abbara S et al. 2011 Guideline on the Management of Patients With Extracranial Carotid and Vertebral Artery Disease: Executive Summary. Stroke. 2011; 42(8): 420-63.