Left, Then Right Internal Carotid Artery Dissection: A Case Report
Introduction: We present a unique case of a patient who presented to the emergency department with stroke-like symptoms found to have a spontaneous, left-sided internal carotid artery dissection (ICAD). Case Report: The patient was treated successfully with thrombectomy and subsequently developed co...
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| Format: | Article |
| Language: | English |
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eScholarship Publishing, University of California
2024-10-01
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| Series: | Clinical Practice and Cases in Emergency Medicine |
| Online Access: | https://escholarship.org/uc/item/5fr4n7pg |
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| author | Jeffrey M. Kalczynski John Douds Michael E. Silverman |
| author_facet | Jeffrey M. Kalczynski John Douds Michael E. Silverman |
| author_sort | Jeffrey M. Kalczynski |
| collection | DOAJ |
| description | Introduction: We present a unique case of a patient who presented to the emergency department with stroke-like symptoms found to have a spontaneous, left-sided internal carotid artery dissection (ICAD). Case Report: The patient was treated successfully with thrombectomy and subsequently developed contralateral symptoms caused by a right-sided ICAD. This was managed with a second contra-lateral thrombectomy. The patient’s course was complicated by persistent and mild hypotension, postulated to be secondary to bilateral carotid baroreceptor trauma from the dissections. Conclusion: This case highlights the importance of close neurological monitoring for patients, preferably in a neurologic critical care setting, during and after invasive treatments such as systemic thrombolytic administration or mechanical thrombectomy. In this case, identifying the patient’s subsequent development of contralateral symptoms in a timely fashion was key to his positive outcome. An additional factor that had a positive impact on this outcome was the use of artificial intelligence software, which assists in determining whether thrombectomy may be indicated prior to receiving a formal radiologist read on computed tomography angiography/perfusion studies. Artificial intelligence technology such as this has great potential to augment and expedite patient care. |
| format | Article |
| id | doaj-art-9ee7b28237a2407680657c4da437e189 |
| institution | DOAJ |
| issn | 2474-252X |
| language | English |
| publishDate | 2024-10-01 |
| publisher | eScholarship Publishing, University of California |
| record_format | Article |
| series | Clinical Practice and Cases in Emergency Medicine |
| spelling | doaj-art-9ee7b28237a2407680657c4da437e1892025-08-20T02:57:01ZengeScholarship Publishing, University of CaliforniaClinical Practice and Cases in Emergency Medicine2474-252X2024-10-018436536810.5811/cpcem.21189cpcem-8-365Left, Then Right Internal Carotid Artery Dissection: A Case ReportJeffrey M. Kalczynski0John Douds1Michael E. Silverman2Morristown Medical College, Department of Emergency Medicine, Morristown, New JerseySidney Kimmel Medical College, Philadelphia, PennsylvaniaMorristown Medical College, Department of Emergency Medicine, Morristown, New JerseyIntroduction: We present a unique case of a patient who presented to the emergency department with stroke-like symptoms found to have a spontaneous, left-sided internal carotid artery dissection (ICAD). Case Report: The patient was treated successfully with thrombectomy and subsequently developed contralateral symptoms caused by a right-sided ICAD. This was managed with a second contra-lateral thrombectomy. The patient’s course was complicated by persistent and mild hypotension, postulated to be secondary to bilateral carotid baroreceptor trauma from the dissections. Conclusion: This case highlights the importance of close neurological monitoring for patients, preferably in a neurologic critical care setting, during and after invasive treatments such as systemic thrombolytic administration or mechanical thrombectomy. In this case, identifying the patient’s subsequent development of contralateral symptoms in a timely fashion was key to his positive outcome. An additional factor that had a positive impact on this outcome was the use of artificial intelligence software, which assists in determining whether thrombectomy may be indicated prior to receiving a formal radiologist read on computed tomography angiography/perfusion studies. Artificial intelligence technology such as this has great potential to augment and expedite patient care.https://escholarship.org/uc/item/5fr4n7pg |
| spellingShingle | Jeffrey M. Kalczynski John Douds Michael E. Silverman Left, Then Right Internal Carotid Artery Dissection: A Case Report Clinical Practice and Cases in Emergency Medicine |
| title | Left, Then Right Internal Carotid Artery Dissection: A Case Report |
| title_full | Left, Then Right Internal Carotid Artery Dissection: A Case Report |
| title_fullStr | Left, Then Right Internal Carotid Artery Dissection: A Case Report |
| title_full_unstemmed | Left, Then Right Internal Carotid Artery Dissection: A Case Report |
| title_short | Left, Then Right Internal Carotid Artery Dissection: A Case Report |
| title_sort | left then right internal carotid artery dissection a case report |
| url | https://escholarship.org/uc/item/5fr4n7pg |
| work_keys_str_mv | AT jeffreymkalczynski leftthenrightinternalcarotidarterydissectionacasereport AT johndouds leftthenrightinternalcarotidarterydissectionacasereport AT michaelesilverman leftthenrightinternalcarotidarterydissectionacasereport |