42-year-old woman presenting with headache

Images

Doctor's Information

Name : Hamidreza
Family :Haghighatkhah
Affiliation : Radiology department,ShohadaTajrish Hospital,SBMU
Academic Degree: Associate professor of Radiology
Email : This email address is being protected from spambots. You need JavaScript enabled to view it.
Resident : Hussein Soleiman Tabar

Patient's Information

Gender : Female
Age : 42

Case Section

Interventional Radiology

Clinical Summary

42-year-old woman presenting with headache and right hemiparesis after trauma

Imaging Procedures and Findings

Images from left common carotid arteriogram depict long-segment smooth narrowing of internal carotid artery, beginning from its proximal portion and extending up to the skull base.

Discussion

Dissection of internal carotid artery often occurs spontaneously and is mainly seen in middle aged patients. It usually starts about 2 cm distal to the carotid bifurcation, and may extend up to the skull base, the carotid canal or even into the cavernous sinus. The most frequent symptom is ipsilateral headache, usually frontotemporal. Other symptoms may be associated, such as Horners syndrome and paralysis of an upper cranial nerve. The diagnosis can be suspected on ultrasound and confirmed by angiography, but is also readily made on axial MR images: the internal carotid artery appears enlarged and shows a high signal intensity zone, corresponding to the mural hematoma, eccentrically situated with respect to the lumen if this is not completely occluded.

Final Diagnosis

Dissection of internal carotid artery

References

www.medcyclopaedia.com/library/topics/volume_vi_2/i/internal_carotid_artery_dissection.aspx?s=carotid+dissection&mode=1&syn=&scope=