SPONTANEOUS INTERNAL CAROTID-ARTERY DISSECTION - REVIEW

Spontaneous ICA dissection is an increasingly recognized cause of stro ke especially in young adults, The most frequently reported site of in volvement is the cervical part of the internal carotid artery (ICA). A lthough several primary arteriopathies have been related to the develo pment of spontaneous ICA dissection the cause is not clear in most cas es. The clinical picture varies fi om mild cerebral and/or cranial ner ve dysfunction to a completed stroke. Angiography has been considered as gold standard in establishing diagnosis. Recently, duplex scanning has emerged as a powerful noninvasive diagnostic tool only in the init ial assessment but in the serial followup of patients. Early diagnosis is essential as these lesions require anticoagulant treatment. Immedi ate heparinization is instituted after diagnosis, followed by oral ant icoagulation for at least six months. Surgical treatment is warranted in only few cases. Complete resolutione of the dissection is seen in a t least 50% of cases. The risk of recurrent stroke remains low in pati ents discarged alive after spontaneous ICA dissection.