2018 Volume 40 Issue 2 Pages 81-85
We report a case of spontaneous internal carotid artery dissection, and discuss the etiology of the dissection. A 30-year-old man usually leaned his head when he slept. One day, he complained of right hemiplegia, motor aphasia, and neck pain after he woke up. MRI demonstrated small infarctions on the left basal ganglia and deep white matter, and MRA demonstrated the pseudo-occlusion of the left internal carotid artery (ICA). We diagnosed the dissection of the left ICA. We treated him medically first, because he was asymptomatic on admission. However, 4 days after onset, the dissection was not improved at all. Then, we decided to perform endovascular stenting for the dissection. After the treatment, the lesion was completely improved. On day 15 after admission, the patient was discharged without any neurological deficit. In this case, the mechanism of dissection of the internal carotid artery seemed to be associated with the lateral extension of the neck when sleeping.
