Skip to main content
Log in

Traumatic and spontaneous extracranial internal carotid artery dissections

  • Original Investigations
  • Published:
Journal of Neurology Aims and scope Submit manuscript

Summary

Seventy patients with spontaneous and 21 with traumatic extracranial internal carotid artery dissections were studied clinically and angiographically with mean follow-ups of 64 (spontaneous group) and 40 months (traumatic group). Sixty percent of the patients in the spontaneous group and 71% in the traumatic group also had follow-up angiograms. In traumatic dissections aneurysms were common, significantly fewer aneurysms resolved or became smaller and fewer stenoses resolved or improved, whereas more stenoses progressed to occlusion. Traumatic dissections were more likely to leave the patients with neurological deficits. A significantly higher percentage of the patients with spontaneous dissections were asymptomatic at follow-up compared with the traumatic group. Although both spontaneous and traumatic dissections of extracranial internal carotid arteries mostly carry a good prognosis, the outcome may be somewhat less favorable for the traumatic group.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Similar content being viewed by others

References

  1. Anderson RM, Schechter MM (1959) A case of spontaneous dissecting aneurysm of the internal carotid artery. J Neurol Neurosurg Psychiatry 22:195–201

    Google Scholar 

  2. Anderson WAD, Scotti TM (1980) Synopsis of pathology, 10th edn. Mosby, St. Louis, pp 290–293

    Google Scholar 

  3. Batzdorf U, Bentson JR, Machleder HI (1979) Blunt trauma to the high cervical carotid artery. Neurosurgery 5:195–201

    Google Scholar 

  4. Bogousslavsky J, Despland P-A, Regli F (1987) Spontaneous carotid dissection with acute stroke. Arch Neurol 44:137–140

    Google Scholar 

  5. Bradac GB, Kaernbach A, Bolk-Weischedel D, Finck GA (1981) Spontaneous dissecting aneurysm of cervical cerebral arteries: report of six cases and review of the literature. Neuroradiology 21:149–154

    Google Scholar 

  6. Brice JG, Crompton MR (1964) Spontaneous dissecting aneurysms of the cervical internal carotid artery. Br Med J 2:790–792

    Google Scholar 

  7. Brown OL, Armitage JL (1973) Spontaneous dissecting aneurysms of the cervical internal carotid artery: two case reports and a survey of the literature. Am J Roentgenol 118:648–653

    Google Scholar 

  8. Davis JM, Zimmerman RA (1983) Injury of the carotid and vertebral arteries. Neuroradiology 25:55–69

    Google Scholar 

  9. Dragon R, Saranchak H, Lakin P, Strauch G (1981) Blunt injuries to the carotid and vertebral arteries. Am J Surg 141:497–500

    Google Scholar 

  10. Ehrenfeld WK, Wylie EJ (1976) Spontaneous dissection of the internal carotid artery. Arch Surg 111:1294–1301

    Google Scholar 

  11. Fisher CM, Ojemann RG, Roberson GH (1978) Spontaneous dissection of cervico-cerebral arteries. Can J Neurol Sci 5:9–19

    Google Scholar 

  12. Friedman WA, Day AL, Quisling RG, Sypert GW, Rhoton AL Jr (1980) Cervical carotid dissecting aneurysms. Neurosurgery 7:207–214

    Google Scholar 

  13. Hart RG, Easton JD (1983) Dissections of cervical and cerebral arteries. Neurol Clin 1:155–182

    Google Scholar 

  14. Houser OW, Mokri B, Sundt TM Jr, Baker HL Jr, Reese DF (1984) Spontaneous cervical cephalic arterial dissection and its residuum: angiographic spectrum. AJNR 5:27–34

    Google Scholar 

  15. Krajewski LP, Hertzer NR (1980) Blunt carotid artery trauma: report of two cases and review of the literature. Ann Surg 191:341–346

    Google Scholar 

  16. Mokri B (1987) Dissections of cervical and cephalic arteries. In: Sundt TM Jr (ed) Occlusive cerebrovascular disease: diagnosis and surgical management. Saunders, Philadelphia, pp 38–59

    Google Scholar 

  17. Mokri B, Piepgras DG, Sundt TM Jr, Pearson BW (1982) Extracranial internal carotid artery aneurysms. Mayo Clin Proc 57:310–321

    Google Scholar 

  18. Mokri B, Sundt TM Jr, Houser OW, Piepgras DG (1986) Spontaneous dissection of the cervical internal carotid artery. Ann Neurol 19:126–138

    Google Scholar 

  19. Mokri B, Piepgras DG, Houser OW (1988) Traumatic dissections of the extracranial internal carotid artery. J Neurosurg 68:189–197

    Google Scholar 

  20. Momose KJ, New PFJ (1973) Non-atheromatous stenosis and occlusion of the internal carotid artery and its main branches. Am J Roentgenol 118:550–566

    Google Scholar 

  21. Ojemann RG, Fisher CM, Rich JC (1972) Spontaneous dissecting aneurysm of the internal carotid artery. Stroke 3:434–440

    Google Scholar 

  22. Stringer WL, Kelly DL Jr (1980) Traumatic dissection of the extracranial internal carotid artery. Neurosurgery 6:123–130

    Google Scholar 

  23. Thapedi IM, Ashenhurst EM, Rozdilsky B (1970) Spontaneous dissecting aneurysm of the internal carotid artery in the neck: report of a case and review of the literature. Arch Neurol 23:549–554

    Google Scholar 

  24. Zelenock GB, Kazmers A, Whitehouse WM Jr, Graham LM, Erlandson EE, Cronenwett JL, Lindenauer SM, Stanley JC (1982) Extracranial internal carotid artery dissections: noniatrogenic traumatic lesions. Arch Surg 117:425–432

    Google Scholar 

Download references

Author information

Authors and Affiliations

Authors

Rights and permissions

Reprints and permissions

About this article

Cite this article

Mokri, B. Traumatic and spontaneous extracranial internal carotid artery dissections. J Neurol 237, 356–361 (1990). https://doi.org/10.1007/BF00315659

Download citation

  • Received:

  • Revised:

  • Accepted:

  • Issue Date:

  • DOI: https://doi.org/10.1007/BF00315659

Key words

Navigation