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Bilateral Spontaneous Dissection of the Internal Carotid Arteries

A Case Report

James M. Goff, Jr, MD

David L. Gillespie, MD

Peripheral Vascular Surgery Service, Walter Reed Army Medical Center, Washington, DC; Department of Surgery, Uniformed Services University of the Health Sciences, Bethesda, Maryland

Stanley L. Minken, MD

Department of Surgery, Uniformed Services University of the Health Sciences, Bethesda, Maryland; Department of Surgery, Johns Hopkins University, Baltimore, MD

A 41-year-old African American man presented with an acute stroke secondary to bilateral spontaneous internal carotid artery dissections following exercise. Spontaneous bilateral carotid artery dissection is an unusual and uncommon occurrence that can be successfully diagnosed by color-flow duplex ultrasonography and magnetic resonance imaging/magnetic resonance angiography (MRI/MRA) imaging. A review of the literature and the authors' experience supports initial medical management of these patients. Surgery should be considered for those patients who exhibit progressive neurologic symptoms during medical management or when significant carotid artery complications, aneurysms, or flow-limiting stenoses persist.

Vascular and Endovascular Surgery, Vol. 35, No. 3, 221-224 (2001)
DOI: 10.1177/153857440103500310


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