Isolated internal carotid artery dissection after a motorcycle accident: A case report

Extra cranial carotid artery dissection is one of the most important complications associated with blunt head and neck trauma. It is a major cause of ischemic stroke in young adults. We report a case of internal carotid artery dissection which caused transient hemiparesis, horizontal gaze to right and anisocoria in a 19-year-old male motorcyclist involved in a collision. Unenhanced brain computed tomography scan showed well defined infarction in the right frontotemporoparietal area. Digital subtraction angiography showed complete occlusion of the proximal cervical right internal carotid artery. Moreover, intimal dissection was observed in distal cervical left internal carotid artery which did not limit blood flow to the brain. A stent was placed at the site of dissection in the left internal carotid artery. Intravenous heparin was commenced to avoid further thrombosis. He was discharged home 40 days after the accident with oral anticoagulation. Extra cranial carotid artery dissection is a rare condition which may happen after a non-significant neck trauma. Accordingly, the diagnosis of a cervical vascular dissection requires strong clinical suspicion.