Bilateral internal carotid artery dissection due to trivial trauma

Internal carotid artery dissection (ICAD) is a known cause of unilateral headache and focal cerebral ischemic symptoms. Other symptoms include oculosympathetic paresis, facial pain, neck pain, subjective carotid bruits, and cranial nerve deficits. Traumatic dissection has an obvious precipitating incident preceding the neurologic or visual symptoms, An ICAD that occurs spontaneously or from trivial trauma usually lacks an obvious incident and thus requires awareness of its possibility for accurate detection and treatment. Dissections arise from a defect in the internal elastic lamina allowing penetration of blood into the arterial mall, Despite its low incidence, ICAD must be considered in young to middle-aged patients who present with headache and transient cerebral or retinal ischemic symptoms. This report describes a patient who had bilateral internal carotid artery dissections following trivial trauma. The etiologies, clinical manifestations, diagnostic modalities, treatment options, and outcomes of ICAD are discussed. (C) 2000 Elsevier Science Inc.