Vascular and endovascular surgery · 2016
Vocal Cord Paralysis as the First Sign of Spontaneous Carotid Dissection in a Patient With Extracranial Internal Carotid Artery Aneurysm.
Клинический случайСтатьяПоддержка исследования: вне правительства СШАНазвание и аннотация: Перевод пока не подготовлен
Обработка статьи · этапы, ошибки и управление
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История · было → стало
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Popov Petar, Chapot Rene, Tanasković Slobodan, Vekić Berislav, Sotirovic Vuk, Ilijevski Nenad, Radak Djordje
Аннотация
INTRODUCTION: Spontaneous dissection of supra-aortic arteries is an exceptionally rare cause of vocal cord dysfunction. We are reporting a case of spontaneous carotid dissection and internal carotid artery aneurysm presenting as vocal cord paralysis.
CASE REPORT: A 44-year-old female was admitted with hoarseness and swallowing disorders. Diagnostic imaging revealed dissection and obliteration of the right internal carotid artery (ICA) 23 mm from the carotid bifurcation. Electromyography revealed unilateral paralysis/paresis of the right vocal cord. Genetic analyses for thrombophilia, methylenetetrahydrofolate reductase, and plasminogen activator inhibitor 1 were found to be at high risk. The patient was discharged after 5 days without any neurological findings, and control angiography revealed complete restitution of the flow in the right ICA one month later. However, a fusiform aneurysm of the distal part of the extracranial right ICA was detected and excluded with endovascular procedure.
CONCLUSION: Connective tissue systemic disorders and even mild trauma could initiate the dissection process of neck arteries. Precise diagnosis might be difficult even for an experienced neurologist, however, the final outcome is favorable.
CASE REPORT: A 44-year-old female was admitted with hoarseness and swallowing disorders. Diagnostic imaging revealed dissection and obliteration of the right internal carotid artery (ICA) 23 mm from the carotid bifurcation. Electromyography revealed unilateral paralysis/paresis of the right vocal cord. Genetic analyses for thrombophilia, methylenetetrahydrofolate reductase, and plasminogen activator inhibitor 1 were found to be at high risk. The patient was discharged after 5 days without any neurological findings, and control angiography revealed complete restitution of the flow in the right ICA one month later. However, a fusiform aneurysm of the distal part of the extracranial right ICA was detected and excluded with endovascular procedure.
CONCLUSION: Connective tissue systemic disorders and even mild trauma could initiate the dissection process of neck arteries. Precise diagnosis might be difficult even for an experienced neurologist, however, the final outcome is favorable.