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Isolated internal carotid artery dissection in a long-distance runner
Krzysztof Wachal1, Paweł Koczewski2, Marcin Gabriel1
1First Department and Clinic of General and Vascular Surgery, Poznan University of Medical Sciences, Przemienienia Pańskiego Clinical Hospital, Poznan, Poland.
Summary
A marathon runner experienced temporary binocular vision loss due to internal carotid artery dissection (ICAD). Prompt diagnosis and stent implantation led to a good clinical outcome, highlighting the importance of specific ultrasound techniques for ICAD detection.
Area of Science:
- Vascular Neurology
- Cardiovascular Surgery
- Ophthalmology
Background:
- Internal carotid artery dissection (ICAD) can present with diverse neurological symptoms.
- Precranial ICAD, though less common, poses diagnostic challenges.
Observation:
- A 49-year-old male marathon runner developed transient binocular visual impairment.
- Symptoms resolved spontaneously after 3 hours but imaging confirmed internal carotid artery dissection.
- No ophthalmologic abnormalities were detected.
Findings:
- Vascular surgery with stent implantation was successful after 6 weeks of ineffective non-invasive treatment.
- Detailed diagnostics and timely intervention resulted in a favorable clinical outcome.
Implications:
- This case underscores the importance of considering ICAD in patients with transient visual disturbances, even with spontaneous resolution.
- Standard Doppler ultrasound protocols should be augmented with curved transducer evaluation of the proximal internal carotid artery for improved ICAD detection.
