[A Case of Traumatic Carotid Artery Dissection Treated with Mechanical Thrombectomy Followed by Carotid Artery Stenting]

No Shinkei Geka. 2020 Dec;48(12):1171-1176. doi: 10.11477/mf.1436204341.
[Article in Japanese]

Abstract

Traumatic carotid artery dissection(TCAD)is often associated with severe traumatic brain injuries and has high rates of morbidity and mortality. Here, we report a case of TCAD that was treated with mechanical thrombectomy followed by carotid artery stenting(CAS). A 50-year-old man suffered from minor facial trauma due to a motorcycle accident and had disturbance of consciousness with left hemiplegia 2 hours after sustaining the injury. Magnetic resonance imaging scans revealed cerebral infarction in a part of the middle cerebral artery territory, and magnetic resonance angiography showed cervical internal carotid artery occlusion. The patient was diagnosed with TCAD and underwent acute revascularization. Complete recanalization was with a combined technique using a stent-retriever and an aspiration catheter. Carotid angiography revealed a dissection of the internal carotid artery on the right side, and CAS was performed on the right side. Postoperatively, the patient recovered from disturbance of consciousness and left hemiplegia and was discharged once he was ambulatory. In cases of worsening symptomatology or worsening imaging findings, an endovascular approach should be considered for the treatment of TCAD.

Publication types

  • Case Reports

MeSH terms

  • Carotid Artery, Internal
  • Dissection
  • Humans
  • Male
  • Middle Aged
  • Middle Cerebral Artery
  • Stents*
  • Thrombectomy*