Traumatic bilateral internal carotid artery dissection following airbag deployment in a patient with fibromuscular dysplasia

This case describes a 39-yr-old male, presenting with left hemiplegia after a road traffic accident involving frontal deceleration and airbag deployme nt. Brain computerized tomography (CT) scan revealed a right parietal lobe infarct. Contrast angiography demonstrated bilateral internal carotid arter y dissection and fibromuscular dysplasia. The patient was treated with syst emic heparinization. Neurological improvement, evidenced by full return of touch sensation, proprioception and nociception began 10 days after the inj ury. To our knowledge, this is the first case report of carotid artery diss ection associated with airbag deployment. Forced neck extension in such set tings may result in carotid artery dissection because of shear force injury at the junction of the extracranial and intrapetrous segments of the vesse l. Clinicians should consider carotid artery injury when deterioration in n eurological status occurs after airbag deployment, We propose that the risk of carotid artery dissection was increased by the presence of fibromuscula r dysplasia.