Dissection of bilateral internal carotid arteries and occlusion of both vertebral arteries in a child patient

The early diagnosis of cervical vascular trauma is critical in the prevention of cerebral ischemia. Traumatic carotid or vertebral artery dissection is rare and frequently associated with other injuries. Diagnosis is often delayed, limiting treatment options and contributing to a poor outcome. With modern methods of investigation and management, the prognosis of this condition may be improved. Doppler ultrasound investigations show signs of distal stenosis or occlusion, highly suggestive of dissection, but the best diagnostic tools are MRA or intraarterial angiography. We present a case with dissection of bilateral internal carotid arteries and occlusion of both vertebral arteries because of its rarity. Furthermore we emphasize that recurrent arterial dissections should be taken into consideration in stroke events, even if the history of neck trauma is remote, and cerebral artery dissection is investigated routinely.