Complex traumatic dissection of right vertebral and bilateral carotid arteries: a case report and literature review

A 27-year-old female motorcycle passenger was admitted with bruises and con cussion after a motor-vehicle accident. After a lucid interval of several h ours she became stuporous and progressed to an acute comatose state. Comput ed tomography demonstrated extensive cerebral ischaemia in the territory of the right middle cerebral artery. Angiography after transfer to the author s' hospital revealed dissections of both carotid arteries and of the right vertebral artery. The patient underwent surgical reconstruction of the left internal carotid artery with saphenous vein. The management of this patien t is discussed and the literature reviewed. (C) 2000 The International Soci ety for Cardiovascular Surgery. Published by Elsevier Science Ltd. All righ ts reserved.