Bilateral internal carotid artery dissection due to trivial trauma

Internal carotid artery dissection (ICAD) is a known cause of unilateral he adache and focal cerebral ischemic symptoms. Other symptoms include oculosy mpathetic paresis, facial pain, neck pain, subjective carotid bruits, and c ranial nerve deficits. Traumatic dissection has an obvious precipitating in cident preceding the neurologic or visual symptoms, An ICAD that occurs spo ntaneously or from trivial trauma usually lacks an obvious incident and thu s requires awareness of its possibility for accurate detection and treatmen t. Dissections arise from a defect in the internal elastic lamina allowing penetration of blood into the arterial mall, Despite its low incidence, ICA D must be considered in young to middle-aged patients who present with head ache and transient cerebral or retinal ischemic symptoms. This report descr ibes a patient who had bilateral internal carotid artery dissections follow ing trivial trauma. The etiologies, clinical manifestations, diagnostic mod alities, treatment options, and outcomes of ICAD are discussed. (C) 2000 El sevier Science Inc.