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A Case with Traumatic Internal Carotid Artery Dissection in which the Extent of the Pseudolumen was Defined by MK Angiography Kazuo OKUCHI 1 , Kiyoshi NAGATA 1 , Masayuki FUJIOKA 1 , Yuji MAEDA 1 , Hiroshi YOKOTA 1 , Toshikazu NISHIOKA 1 , Tadashi KAGOSIMA 1 1Department of Neurosurgery, Nara Emergency and Critical Care Center Keyword: dissection , dissecting aneurysm , trauma , MRA , MRI pp.889-894
Published Date 1999/10/10
DOI https://doi.org/10.11477/mf.1436901786
  • Abstract
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We report a 29-year-old male with traumatic internal carotid artery (ICA) dissection who presented withcerebral ischemia developed after removal of a left acute subdural hematoma and external decompression.CT scans 4 days after the operation showed infarctions of the distribution of the bilateral cerebral hemi-spheres. Cerebral angiography on the 11th hospital day demonstrated narrowing of the extracranial internalcarotid artery at C1-C2 vertebral levels. Slight arterial dilatation and retention of the contrast medium werefound just above the narrowing segment, which was suspected to be a pseudolumen. Three D time-of flight MRA showed an intramural hematoma corresponding to the narrowing on the angiography. Originalaxial MRA images showed that narrowing of the lumen was surrounded by a crescent hematoma and thattwo flow velocity areas were in the area distal to the narrowing. High flow seemed to be ordinary artery flow rate. The low flow area, including turbulent flow, led to the retention of contrast medium mimicking apseudolumen.

Precise MRA imaging will bring us an accurate diagnosis of extracranial carotid dissections.


Copyright © 1999, Igaku-Shoin Ltd. All rights reserved.

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電子版ISSN 1882-1251 印刷版ISSN 0301-2603 医学書院

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