Abstract
Objective: To review the treatment of cervical internal carotid artery dissection resulting in intracranial large vessel occlusion. Methods: Two hundred and ninety patients who underwent mechanical thrombectomy at our hospital from April 2015 to March 2022 were included. The diagnosis was comprehensive, including clinical symptoms and imaging findings. Initial symptoms, neurological findings, images, treatments, and outcomes were collected retrospectively. Results: The study included five patients (2%) with cervical internal carotid artery dissection. The mean age of the patients was 47 years, accounting for 26% (4/19) among those under 55 years. Only two of the five patients presented with head or neck pain. For cervical internal carotid artery dissection, three patients underwent percutaneous transluminal angioplasty. Of these three patients, one patient underwent parent artery occlusion and another underwent carotid artery stenting one month later. The other two patients were treated conservatively for internal carotid artery dissection. All patients showed improved symptoms after treatment. Conclusion: Internal carotid artery dissection is a common cause of severe stroke in young patients, even in the absence of pain. Mechanical thrombectomy is effective in the treatment of intracranial large vessel occlusion due to cervical internal carotid artery dissection. Good outcomes were achieved in this study with individualized case-specific treatment.
