S. Andonova-Atanasova 1, F. Kirov 1, Ch. Bachvarov 2, V. Velinov 2
1 Department of Neurology, Second Clinic of Neurology,
2 Department of Radiology, University Hospital St. Marina – Varna, Bulgaria
Objective: The term dissection refers primarily to an elevation or separation of the intimal lining of an artery from the subjacent media and, less frequently, to separation of the media from the adventitia. Dissection is usually accompanied by hemorrhage into the arterial wall. According to the literature serious vascular injurie to the neck may be asymptomatic or masked by other life-threatening conditions.
Material and Methods: We observed one patient - 44 years old men, with multiple trauma to the neck and left leg, three months before the hospitalization, suffering from acute ischemic stroke. There were no risk factors for cerebrovascular disease. CT angiography was obtained by Spiral Scanner with reconstructions and interpretation by a radiologist. Color-coded duplex sonography was used to determine the extracranial blood flow velocity and the wall of carotid arteries.
Results: Angiographic examination revealed a dissection of left common (distal part) and left internal carotid artery (proximal part) - 6.5 cm long. Considerably higher peak systolic velocity (PCV) and asymmetry PSV left/right ratio of common carotid artery was found.
Discussion: According to our study CT angiography of the carotid arteries and color-coded duplex sonography in cervical trauma may be used as an accurate decisive tools for a needed surgical intervention. More studies with larger number of patients and comparison with angiography and sonography are needed.
Key words: acute ischemic stroke, color coded duplex sonography, CT angiography, dissection of carotid artery.