Abstract
A 43-year-old woman was admitted to our hospital at 12 hours after onset because of left hemiparesis. On admission, she was alert, but displayed severe left hemiparesis. CT revealed a small low density area in the right internal capsule. Administration of sodium ozagrel and edaravone was initiated. After admission, her hemiparesis gradually became aggravated. CT at 2 days after onset showed a small infarction in the region of the frontal lobe. Right carotid angiography demonstrated string-like narrowing of C1-C2, so that anticoagulation therapy was started. On the 11th day, the patient became confused. On the 12th day, CT showed infarction in the region of the middle cerebral artery. A 3D CT angiogram revealed that the distal portion of the internal carotid artery (ICA) was occluded. On the 24th day, she became drowsy, and CT showed massive cerebral infarction in the right hemisphere. External decompression was therefore performed, and her consciousness improved after the operation.
Repeat angiography after 3 months showed recanalization of the right ICA.
Intracranial ICA dissection is rare. We therefore present our case together with a literature review of 13 cases.
