1999 Volume 21 Issue 3 Pages 323-328
We report a case of cervical carotid dissection in which cerebral angiography revealed stenosis, occlusion, and spontaneous resolution over time. A 56-year-old man admitted to our hospital with transient ischemic attack suffered right hemiplegia and aphasia. Left cerebral angiography conducted on the following day showed an irregularity in the wall of the cervical internal carotid artery. Cerebral angiography one week later dis-closed an occlusion in the left cervical internal carotid artery. Right cerebral angiography demonstrated bypass blood flow through the anterior communicating artery, but no difference was observed between the left and right hemispheres on single-photon emission computed tomography (SPECT). Conservative therapy was therefore carried out. Nineteen months later, the left internal carotid artery was evident on MRA. Left cerebral angiography revealed only a notable meandering in the cervical internal carotid artery, where the irregularity in the wall had been observed at initial cerebral angiography-a result which indicated complete resolution. Time-course observation is considered necessary because spontaneous resolution can occur even after occlusion in some patients with carotid dissection.
