Severe spontaneous carotid artery dissection and multiple aneurysmal dilatations. A case report

Spontaneous cervical artery dissections or arterial aneurysms associated with deficiencies of alpha(1)-antitrypsin (alpha(1)-AT) or other inhibitors of proteolytic enzymes have occasionally been reported. However, a coexistence of severe spontaneous internal carotid artery dissection and multiple aneurysmal dilatations associated with alpha(1)-AT phenotype M1S have not yet been presented; herein the authors describe such a patient. In order to avoid the risks associated with intraarterial angiography in a patient in whom an underlying arteriopathy is suspected, only noninvasive techniques were employed. This case demonstrates that magnetic resonance imaging combined with magnetic resonance angiography is a valuable noninvasive method for use in diagnosis and follow-up of carotid artery dissection.