Spontaneous and simultanous dissection of the carotid and vertebral artery

Cervical-artery dissection, the major cause of cerebral ischemia in young adults, is a dynamic process: morphological and clinical findings may change within days or hours.

Cervical-arteries dissections are associated with hematoma in the wall of the artery. The intramural hematoma can expand towards the intima (resulting in a stenosis of the artery), or the adventitia (resulting in an aneurysmal dilatation of the artery).

It is possible that the spontaneous dissection of the internal carotid artery (ICA) and vertebral artery (VA) occurs simultaneously: in a review of 200 patients with spontaneous extracranial artery dissection, ICA and VA were simultaneously affected in 6% of cases.

In this lesson, the case of a young adult with a spontaneous and simultaneous dissection of the ICA and VA will be presented: in particular the importance of the echo-color Doppler in acute phase and in the follow-up will be shown.

Franco Accorsi, MD

Member of the Order of Physician of Bologna n° 6728

I am a specialist in Medical Angiology and I am based in Bologna, Italy. Until 2008 (voluntary resignation) I worked at Maggiore Hospital in Bologna as "Dirigente Medico" in the Department of Internal Medicine and as Angiologist in the Angiology Unit with a position of "Alta Professionalità" in "Vascular Ecography and Angiology".
I am currently working in Bologna as an independent professional in the areas of angiology and vascular diagnostics.
I have been a speaker at national and international courses/congress and I have taught duplex ultrasound method in GIUV and SIUMB courses at the Maggiore Hospital, Bologna and courses of echocolor Doppler of extracranial and intracranial arteries at the Stroke Unit of S. Maria Nuova Hospital, Reggio Emilia.