Spontaneous asymptomatic common carotid artery dissection resembling a carotid web: illustrative case.

Autor:	Takahashi T; Departments of Neurosurgery, Tsukuba Memorial Hospital, Tsukuba, Ibaraki, Japan., Yanaka K; Departments of Neurosurgery, Tsukuba Memorial Hospital, Tsukuba, Ibaraki, Japan., Aiyama H; Departments of Neurosurgery, Tsukuba Memorial Hospital, Tsukuba, Ibaraki, Japan., Saura M; Departments of Neurosurgery, Tsukuba Memorial Hospital, Tsukuba, Ibaraki, Japan., Kajita M; Departments of Neurosurgery, Tsukuba Memorial Hospital, Tsukuba, Ibaraki, Japan., Takahashi N; Departments of Radiology, Tsukuba Memorial Hospital, Tsukuba, Ibaraki, Japan., Marushima A; Department of Stroke and Cerebrovascular Diseases, University of Tsukuba Hospital, Tsukuba, Ibaraki, Japan.; Department of Neurosurgery, Institute of Medicine, University of Tsukuba, Tsukuba, Ibaraki, Japan., Matsumaru Y; Department of Stroke and Cerebrovascular Diseases, University of Tsukuba Hospital, Tsukuba, Ibaraki, Japan.; Department of Neurosurgery, Institute of Medicine, University of Tsukuba, Tsukuba, Ibaraki, Japan., Ishikawa E; Department of Neurosurgery, Institute of Medicine, University of Tsukuba, Tsukuba, Ibaraki, Japan.
Jazyk:	angličtina
Zdroj:	Journal of neurosurgery. Case lessons [J Neurosurg Case Lessons] 2024 Sep 09; Vol. 8 (11). Date of Electronic Publication: 2024 Sep 09 (Print Publication: 2024).
DOI:	10.3171/CASE24344
Abstrakt:	Background: Carotid artery dissection is a common cause of ischemic stroke, predominantly affecting the internal carotid artery, with rare involvement of the common carotid artery (CCA). The limited literature makes diagnosis and management challenging, particularly in asymptomatic patients. In this report, the authors present a unique case of spontaneous, asymptomatic CCA dissection that resembled a carotid web, shedding light on its clinical spectrum and management. Observations: A 70-year-old man was diagnosed with an intimal flap in the left CCA. Although the findings resembled those of a carotid web, cerebral angiography confirmed the presence of an intimal flap and arterial wall irregularities indicative of vascular dissection. Endarterectomy successfully prevented the stroke, and the postoperative recovery was uneventful. Pathological examination confirmed the diagnosis of CCA dissection. Lessons: Spontaneous CCA dissection, though rare, presents significant diagnostic and therapeutic challenges. Because of morphological similarities, differentiating the diagnosis from a carotid web can be difficult. Available treatment strategies include antiplatelet therapy and surgical intervention. In this case, endarterectomy was chosen to avoid antithrombic treatment in anticipation of further invasive treatments for other conditions. The successful outcome highlights the potential as a treatment option, emphasizing the need for an individualized approach to each patient. https://thejns.org/doi/10.3171/CASE24344.
Databáze:	MEDLINE
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