[Natural history of a bilateral carotid dissection]

The coexistence of arterial dissection in several cervical vessels is exceptional and is usually an accidental finding detected upon performance of an extensive angiographic examination in patients with unilateral manifestations. The absence of previous clinical manifestations related with asymptomatic vessel dissection impedes the knowledge of the time between the different dissections. The case of a bilateral carotid dissection (CD) is presented in which the clinical course permitted the authors to know the interval between both dissections. The patients initially presented manifestations of right CD and, at 15 days, an ictus due to left CD in which the presence of right unilateral asterixis was of note. The time span between both dissections was established as 12-15 days.