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Short-term outcome of carotid dissecting pseudoaneurysm: is it always benign?

  • Loris Poli
  • Dikran Mardighian
  • Massimo Gamba
  • Alessandro Padovani
  • Alessandro Pezzini
Letter to the Editor
  • 26 Downloads

Dear Editor,

A 35-year-old male was admitted to the Emergency Department because of major head trauma. Brain CT showed acute subdural hematoma and right temporal pole parenchymal hemorrhage. He was intubated for airway protection but was extubated successfully soon thereafter. After sedation withdrawal, the neurological examination showed a deficit of the 9th, 10th, 11th, and 12th cranial nerves as well as Horner’s sign, consistent with left Villaret syndrome. Cerebral magnetic resonance angiography displayed left extracranial internal carotid artery dissection along with a dissecting pseudoaneurysm (DP), causing compression of the lower 4 cranial nerves and sympathetic fibers and 80% lumen stenosis (Fig.  1a). Acetylsalicylic acid 100 mg daily was started after the resolution of the hemorrhagic lesions, 1 month after the acute event. At 3-month follow-up evaluation, we observed improvement of compressive signs, whereas neuroimaging indicated no further expansion of the vascular lesion...

Notes

Funding

No financial support was received for this submission.

Compliance with ethical standards

Conflict of interest

The authors declare no conflict of interest related to this publication.

Ethical statement

This article does not contain any studies with human participants or animals performed by any of the authors.

Informed consent

Informed consent was obtained from the patient included in the study.

References

  1. 1.
    Debette S, Leys D (2009) Cervical-artery dissections: predisposing factors, diagnosis, and outcome. Lancet Neurol 8:668–678CrossRefPubMedGoogle Scholar
  2. 2.
    Daou B, Hammer C, Chalouhi N et al (2016) Dissecting pseudoaneurysms: predictors of symptom occurrence, enlargement, clinical outcome, and treatment. J Neurosurg 125(4):936–942CrossRefPubMedGoogle Scholar
  3. 3.
    Larsson SC, King A, Madigan J, Levi C, Norris JW, Markus HS (2017) Prognosis of carotid dissecting aneurysms results from CADISS and a systematic review. Neurology 88:646–652CrossRefPubMedPubMedCentralGoogle Scholar
  4. 4.
    Guillon B, Brunereau L, Biousse V, Djouhri H, Levy C, Bousser MG (1999) Long-term follow-up of aneurysms developed during extracranial internal carotid artery dissection. Neurology 53:117–122CrossRefPubMedGoogle Scholar
  5. 5.
    Benninger DH, Gandjour J, Georgiadis D, Stockli E, Arnold M, Baumgartner RW (2007) Benign long-term outcome of conservatively treated cervical aneurysms due to carotid dissection. Neurology 69:486–487CrossRefPubMedGoogle Scholar
  6. 6.
    Mokri B (1990) Traumatic and spontaneous extracranial internal carotid artery dissections. J Neurol 237(6):356–361CrossRefPubMedGoogle Scholar

Copyright information

© Belgian Neurological Society 2018

Authors and Affiliations

  1. 1.Dipartimento di Scienze Cliniche e Sperimentali, Clinica NeurologicaUniversità degli Studi di BresciaBresciaItaly
  2. 2.Dipartimento di Specialità Medico-Chirurgiche, Scienze Radiologiche e Sanità Pubblica, Sezione di NeuroradiologiaUniversità degli Studi di BresciaBresciaItaly
  3. 3.Stroke Unit, U.O Neurologia VascolareSpedali Civili di BresciaBresciaItaly

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