Internal carotid artery dissection with different interventions and outcomes: two case reports

Area of Science:

• Neurology
• Vascular Medicine
• Radiology

Background:

• Spontaneous internal carotid artery dissection (ICAD) is an uncommon yet significant cause of stroke, particularly in younger populations.
• ICAD often presents with variable and atypical symptoms, making diagnosis challenging.

Observation:

• This report details two cases of ICAD in young men with hypertension but no history of trauma.
• One patient presented with neurological deficits affecting the upper extremity, while the other experienced visual impairment.
• Both cases were diagnosed via vascular imaging, highlighting the importance of advanced diagnostic techniques like three-dimensional T1-weighted volume isotropic turbo spin-echo acquisition.

Findings:

• Despite similar diagnostic pathways, patient prognoses varied significantly.
• One patient achieved recovery following endovascular therapy.
• The other patient was successfully managed with conservative medical treatment.

Implications:

• ICAD necessitates a high index of suspicion in young patients with relevant symptoms, even without apparent trauma.
• Awareness of diverse clinical presentations is vital for timely diagnosis and appropriate management.
• Tailored treatment strategies, aiming for vessel recanalization, are essential for improving patient outcomes in ICAD.