Vocal Cord Paralysis as the First Sign of Spontaneous Carotid Dissection in a Patient With Extracranial Internal Carotid Artery Aneurysm

被引:1
作者
Popov, Petar [1 ,2 ]
Chapot, Rene [3 ]
Tanaskovic, Slobodan [1 ]
Vekic, Berislav
Sotirovic, Vuk [1 ]
Ilijevski, Nenad [1 ]
Radak, Djordje [1 ,4 ]
机构
[1] Dedinje Cardiovasc Inst, Vasc Surg Clin, Heroja Milana Tepica 1 St, Belgrade 11000, Serbia
[2] Univ Belgrade, Sch Med, Belgrade, Serbia
[3] Alfried Krupp Krankenhaus Ruttenscheid, Klin Radiol & Neuroradiol, Essen, Germany
[4] DrDragisa Misovic Univ Med Ctr, Dept Surg, Baddour Pkwy, Lebanon, NH USA
关键词
carotid artery; dissection; vocal cord; paralysis;
D O I
10.1177/1538574415627698
中图分类号
R61 [外科手术学];
学科分类号
摘要
Introduction: Spontaneous dissection of supra-aortic arteries is an exceptionally rare cause of vocal cord dysfunction. We are reporting a case of spontaneous carotid dissection and internal carotid artery aneurysm presenting as vocal cord paralysis. Case Report: A 44-year-old female was admitted with hoarseness and swallowing disorders. Diagnostic imaging revealed dissection and obliteration of the right internal carotid artery (ICA) 23 mm from the carotid bifurcation. Electromyography revealed unilateral paralysis/paresis of the right vocal cord. Genetic analyses for thrombophilia, methylenetetrahydrofolate reductase, and plasminogen activator inhibitor 1 were found to be at high risk. The patient was discharged after 5 days without any neurological findings, and control angiography revealed complete restitution of the flow in the right ICA one month later. However, a fusiform aneurysm of the distal part of the extracranial right ICA was detected and excluded with endovascular procedure. Conclusion: Connective tissue systemic disorders and even mild trauma could initiate the dissection process of neck arteries. Precise diagnosis might be difficult even for an experienced neurologist, however, the final outcome is favorable.
引用
收藏
页码:52 / 56
页数:5
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