SPONTANEOUS DISSECTION OF INTERNAL CAROTI D-ARTERY - 10 CASES

Purpose Spontaneous dissection of the internal carotid artery is a rav e vascular emergency, but represents the first cause of cerebral ischa emia of young patients. Neuro-ophthalmologic symptoms often reveals th e pathology. Methods Ten cases of spontaneous dissection of the infern al artery are reported. The Claude Bernard Homer syndrome is the most frequent symptom typically associated with hemicranial headache. The h eadache involves the ipsilateral forequarter of the head and the neck. Other ophthalmologic symptoms may also reveal the carotid dissection. Results At first, the diagnosis is strongly suspected curing Doppler ultrasonographic examination. During the acute phase, MRI and MRA repl aces advantagiously arteriography, confirming this affection in a non invasive way, and permits investigation of associated vascular patholo gy like fibromuscular dysplasia (15 % of the cases). The patients rece ived anticoagulants in order to prevent thrombo-embolic complications (heparine during the acute phase relayed by AVK). The clinical course is usually favorable with the medical treatment. Conclusion A painful Claude Bernard Horner syndrome strongly evokes a carotid dissection an d the arterial check-up must be realised in emergency : at first, the exploratory methods associates Doppler ultrasonographic examination, M RI, and MRA.