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3 results

  • Case 82 - Ventriculostomyinfection

  • from Section II - Neurocritical care
  • Edited by George A. Mashour, Ehab Farag
  • Book:
    Case Studies in Neuroanesthesia and Neurocritical Care
    Published online:
    03 May 2011
    Print publication:
    03 February 2011, pp 275-276

  • Summary

    Postpartum headache (PPH) caused by internal carotid artery dissection (ICAD) is a rare yet treatable condition with a favorable prognosis when recognized. The consequent hypoperfusion or subsequent distal embolization may lead to an ischemic stroke which is already a recognized risk in the puerperium. Pregnancy and puerperium increase the risk for focal ischemic cerebrovascular events. The hypercoaguable state in pregnancy and the immediate puerperium most certainly contributes to this risk. Extracranial ICAD usually presents as a headache, cervical pain, Horner's syndrome, or pulsatile tinnitus without cerebral ischemia. Magnetic resonance imaging (MRI) can visualize morphological details, while magnetic resonance angiography (MRA) and magnetic resonance venography (MRV) reflect intraluminal blood flow. Surgical intervention in ICAD is only required when anticoagulant therapy does not prevent progressive cerebral ischemic events. Teratogenic effects are severe and include anencephaly and spina bifida.

  • Internal carotid artery dissection following canalith repositioning procedure

  • M Bergin, P Bird, A Wright
  • Journal:
    The Journal of Laryngology & Otology / Volume 124 / Issue 5 / May 2010
    Published online by Cambridge University Press:
    29 September 2009, pp. 575-576
    Print publication:
    May 2010
  • Objective:

    To highlight the possibility of internal carotid artery dissection following canalith repositioning procedures.

    Case report:

    A 52-year-old woman with right posterior canal benign paroxysmal positional vertigo sustained a right carotid artery dissection following a canalith repositioning procedure. The patient also had profound mixed hearing loss associated with otosclerosis, so underwent simultaneous cochlear implantation and occlusion of her posterior semicircular canal, following completion of anticoagulation therapy for her dissection.

    Conclusion:

    While internal carotid artery trauma is a rare adverse outcome following canalith repositioning procedures, clinicians should be aware of this possibility if patients report unusual symptoms following such procedures.

  • Internal carotid artery aneurysm presenting as sinus pain

  • H Al-Reefy, C A Johnson, A Balfour, M Dilkes
  • Journal:
    The Journal of Laryngology & Otology / Volume 121 / Issue 10 / October 2007
    Published online by Cambridge University Press:
    19 March 2007, pp. 1006-1008
    Print publication:
    October 2007

  • Sinusitis and its associated facial pain are frequently seen by ENT surgeons. However, it is important to have a high index of suspicion in cases with atypical symptoms, particularly those with unexplained, unilateral, severe facial pain, and to consider an internal carotid artery dissection. This important diagnosis accounts for almost 20 per cent of all strokes in the young, and anti-coagulation can help to prevent thrombosis and embolism. Two cases are presented for illustration.