Ghorbani Mohammad, Mortazavi Abolghasem, Lafta Ghazwan, Kadkhodazadeh Asl Mahdi, Bahrami Reza, Rahbarian Farhad
Division of vascular and Endovascular Neurosurgery, Firoozgar Hospital, Iran University of Medical Sciences, Tehran, Iran.
Department of Surgery, University of Al-Ameed, Karbala, Iraq.
Caspian J Intern Med. 2022;13(Suppl 3):281-283. doi: 10.22088/cjim.13.0.281.
Cervical carotid dissection is one of the causes of ischemic stroke in young people. Most of the patients with carotid dissection do not have connective tissue diseases (Marfan syndrome, Ehlers-Danlos syndrome). It seems that dissection may occur without an obvious cause or may follow environmental injuries like vigorous neck movements, chiropractic manipulation, emesis, severe coughs, and some infections. We present a case of bilateral carotid dissection in a patient following coronavirus infection and severe coughs.
A 38-year-old right-handed man presented with recurrent episodes of transient right hemiparesis and aphasia. He had a history of coronavirus infection and severe persistent, nonproductive cough 7 days before the onset of his symptoms. Carotid angiography showed tapered flame-like appearance in proximal segment of left ICA starting about 2 cm distal to the carotid bulb caused complete occlusion of left ICA and in right CCA angiography there is pseudo aneurysm in right cervical ICA just before the Petrous segment. In 3 months in follow up DSA there is evidence of complete occlusion of right pseudo aneurysm and recanalization of left ICA without stenosis.
COVID-19 may have role in the processes that eventually led to CAD.
颈内动脉夹层是年轻人缺血性卒中的病因之一。大多数颈内动脉夹层患者并无结缔组织疾病（马凡综合征、埃勒斯-当洛综合征）。夹层似乎可能无明显病因就发生，或者可能继发于如剧烈颈部运动、整脊手法治疗、呕吐、剧烈咳嗽及某些感染等环境损伤。我们报告1例冠状病毒感染及剧烈咳嗽后发生双侧颈内动脉夹层的患者。
一名38岁右利手男性，出现反复发作的短暂性右侧偏瘫和失语。他在症状发作前7天有冠状病毒感染史及严重持续性干咳。颈动脉血管造影显示，左颈内动脉近端约在颈动脉球远端2 cm处呈逐渐变细的火焰状外观，导致左颈内动脉完全闭塞；右颈总动脉血管造影显示，右侧颈内动脉岩骨段之前有假性动脉瘤。随访3个月的数字减影血管造影显示，右侧假性动脉瘤完全闭塞，左颈内动脉再通且无狭窄。
2019冠状病毒病可能在最终导致颈动脉夹层的过程中起作用。
