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KMID : 1159220060010010011
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Journal of Korean Society of Intravascular Neurosurgery
2006 Volume.1 No. 1 p.11 ~ p.16
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Intracranial Internal Carotid Artery Dissection；Report of 10 Patients
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Lim Yong-Cheol
Shin Yong-Sam
Cho Kyung-Gi
Kim Sun-Yong
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Abstract
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Objective：Intracranial internal carotid artery (ICA) dissections are considered uncommon and may produce cerebral ischemia, subarachnoid hemorrhage, and catastrophic prognosis. The risk factor, clinical findings, imaging abnormalities, managements, and prognosis in patients with intracranial ICA dissection have not been described in detail. We report our experience of 10 patients with intracranial ICA dissection.
Methods：Ten patients (4 women), treated between 2003 and 2006, were included with ages ranging from 15 to 60 years (mean age, 35.8 years) and retrospectively analyzed. The mean follow-up was 22.6 months.
Results：Six patients had spontaneous intracranial ICA dissection and 4 patients had a history of head or neck trauma. Nine patients had a stroke (including an associated subarachnoid hemorrhage in 1) among them. One patient had a subarachnoid hemorrhage with carotid-cavernous fistula and basal skull fracture. False lumen or stenosis of the distal ICA with extension to the middle cerebral artery (MCA) and/or anterior cerebral artery (ACA) occurred in 3 patients, proximal MCA in 5, and ACA in 2 patients. Five and 2 patients were immediately treated with anticoagulants and antiplatelet agent, and 3 other patients were treated conservatively. Four patients had not disability, mild and moderate disability in 4, severe disability in 1, and death in 1 patient on the Modified Rankin Scale during follow-up period.
Conclusion：We believe that intracranial ICA dissection is an important cause of young-onset stroke and can have a relatively good prognosis. For this reason, we suggest the need for careful image studies to detect the intracranial ICA dissection.
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KEYWORD
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Intracranial, Internal carotid artery, Dissection
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