INTERNAL CAROTID-ARTERY DISSECTION AFTER REMOTE SURGERY - IATROGENIC COMPLICATIONS OF ANESTHESIA

Background Subintimal dissection with acute occlusion of the internal carotid artery resulting in acute cerebral infarction has not been rep orted as an iatrogenic complication of general anesthesia. Case Descri ptions An anesthetist stretched the neck of a 44-year-old man by ancho ring an anesthesia mask posterior to the angle of the jaw with overlyi ng fingers as the patient struggled during an insufficient inhalationa l mask anesthetic. A 33-year-old man received an endotracheal anesthet ic without struggle, but as he was turned from a supine to a prone pos ition, his head and neck were not immobilized to rotate with his torso during the move. The next day both patients suffered acute cerebral i nfarctions secondary to ICA dissections and occlusions (angiographical ly demonstrated). Conclusions Stretching the soft neck tissues of anes thetized patients can cause internal carotid artery dissection and acu te cerebral infarction.