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Internal carotid artery dissection following self-manipulation: A case report
Kurt Piening1, Nicholas M Piening1, Andy Chiou1
1Department of Surgery, The University of Illinois College of Medicine Peoria, Peoria, IL, USA.
SAGE Open Medical Case Reports
|September 12, 2022
Summary
A rare case of internal carotid artery dissection in a young woman, caused by self-neck manipulation, was successfully treated with anticoagulation and antiplatelet medication. Follow-up imaging showed complete resolution of the dissection and significant symptom improvement.
Area of Science:
- Neurology
- Vascular Surgery
- Radiology
Background:
- Cervical artery dissection is a significant cause of stroke in young adults.
- Symptoms include pain, Horner syndrome, and cranial neuropathies.
- Treatment typically involves anticoagulation, with surgery reserved for severe or recurrent cases.
Observation:
- A healthy 26-year-old female presented with internal carotid artery dissection after self-manipulation of the neck.
- She developed Horner syndrome and significant arterial narrowing.
- This cause of dissection is rare, unlike those reported after professional chiropractic manipulation.
Findings:
- The patient was treated with anticoagulation, transitioning to clopidogrel and atorvastatin.
- Six-month follow-up computed tomography angiography revealed complete resolution of the dissection.
- Significant improvement in symptoms was noted, with only mild residual ptosis.
Implications:
- This case highlights a rare cause of internal carotid artery dissection.
- Successful medical management of spontaneous dissections is demonstrated.
- It underscores the importance of considering self-manipulation as a potential trigger for cervical artery dissection.
