1/80. Endovascular occlusion of a carotid pseudoaneurysm complicating deep neck space infection in a child. Case report.Pseudoaneurysm formation of the cervical internal carotid artery (ICA) is a rare, potentially lethal complication of deep neck space infection. This entity typically occurs following otolaryngological or upper respiratory tract infection. The pseudoaneurysm is heralded by a pulsatile neck mass, Homer's syndrome, lower cranial neuropathies, and/or hemorrhage that may be massive. The recommended treatment includes prompt arterial ligation. The authors present a case of pseudoaneurysm of the cervical ICA complicating a deep neck space infection. A parapharyngeal staphylococcus aureus abscess developed in a previously healthy 6-year-old girl after she experienced pharyngitis. The abscess was drained via an intraoral approach. On postoperative Day 3, the patient developed a pulsatile neck mass, lethargy, ipsilateral Horner's syndrome, and hemoptysis, which resulted in hemorrhagic shock. Treatment included emergency endovascular occlusion of the cervical ICA and postembolization antibiotic treatment for 6 weeks. The patient has made an uneventful recovery as of her 18-month follow-up evaluation. Conclusions drawn.from this experience and a review of the literature include the following: 1) mycotic pseudoaneurysms of the carotid arteries have a typical clinical presentation that should enable timely recognition; 2) these lesions occur more commonly in children than in adults; 3) angiography with a view to performing endovascular occlusion should be undertaken promptly; and 4) endovascular occlusion of the pseudoaneurysm is a viable treatment option.- - - - - - - - - - ranking = 1keywords = carotid, carotid artery, artery (Clic here for more details about this article) |
2/80. Congenital Horner's syndrome resulting from agenesis of the internal carotid artery.OBJECTIVE: To report a patient with agenesis of the right internal carotid artery associated with ipsilateral, congenital Homer's syndrome. DESIGN: Case report. methods: A 30-year-old woman, with a past history of migraine headaches, underwent neuro-ophthalmologic and neuroradiologic evaluation for transient visual obscurations and congenital Horner's syndrome. RESULTS: A right, third-order neuron Horner's syndrome was confirmed with 1% hydroxyamphetamine topical drops. Cranial magnetic resonance imaging revealed an absent right internal carotid artery flow void, computed tomography demonstrated absence of the right carotid canal, and cerebral angiography confirmed absence of the right internal carotid artery. No atheromatous lesions were found and the results of coagulation studies were normal. CONCLUSIONS: Agenesis of the internal carotid artery is a rare cause of congenital Horner's syndrome. The cause of transient visual blurring in the current patient remains unproven.- - - - - - - - - - ranking = 2.4097526450548keywords = carotid, carotid artery, artery (Clic here for more details about this article) |
3/80. MR diagnosis of a congenital abnormality of the thoracic aorta with an aneurysm of the right subclavian artery presenting as a Horner's syndrome in an adult.Congenital abnormality of the aortic arch is a diagnosis made most of the time incidentally in childhood, unless dysphagia or respiratory disorders occur before. A case of a complex aortic arch anomaly with an aneurysm of the right subclavian artery presenting as an isolated Horner's syndrome in an adult is reported herein. magnetic resonance imaging led to this very unusual diagnosis.- - - - - - - - - - ranking = 0.010261845215898keywords = artery (Clic here for more details about this article) |
4/80. Horner's syndrome after carotid artery stenting: case report.BACKGROUND: angioplasty and stenting of various lesions of the carotid artery is gaining in popularity. Our knowledge of the efficacy and limitations of this promising technology is incomplete. Although Horner's syndrome and its variants have been described after traumatic, spontaneous, or surgical carotid dissection, it has not been reported after carotid artery stenting. CASE DESCRIPTION: A 36-year-old woman presented with left neck and ear pain and a 3-year history of rushing noises in her left ear. Angiography demonstrated evidence of dissection of the left internal carotid artery at the skull base with a pseudoaneurysm.The pseudoaneurysm was treated with a 6-mm diameter self-expanding stent in a 4-mm diameter left internal carotid artery. A few hours later, she developed partial Horner's syndrome with a subtle ipsilateral ptosis and miosis without anhidrosis. Angiography performed on the next day did not demonstrate further dissection or aneurysm growth but did show distention of the artery wall because of the stent. She did not develop any further sequelae. CONCLUSION: This case suggests that stretching of the artery wall may result in stretching of surrounding structures. The sympathetic fibers surrounding the internal carotid artery are clearly sensitive to this degree of stretch. Possible complications associated with stretch injury must be considered when choosing the stent diameter.- - - - - - - - - - ranking = 2.697159004302keywords = carotid, carotid artery, artery (Clic here for more details about this article) |
5/80. Horner's syndrome and dissection of the internal carotid artery after chiropractic manipulation of the neck.PURPOSE: To report a case of Horner's syndrome and dissection of the internal carotid artery after chiropractic manipulation of the neck. methods: Case report. A 44-year-old woman with no prior ocular or vascular history presented with severe right-sided head and neck pain, ptosis, and miosis following chiropractic treatment for a strained right shoulder muscle. RESULTS: magnetic resonance angiography of the neck and brain revealed a dissection of the right internal carotid artery as well as a suggestion of subtle dissection in the right vertebral artery. No significant brain abnormalities were noted on magnetic resonance imaging. Pharmacological testing was consistent with preganglionic oculosympathetic damage. CONCLUSION: Acute, painful Horner's syndrome as a manifestation of vascular dissection may be associated with chiropractic manipulation of the neck.- - - - - - - - - - ranking = 1.7018620960084keywords = carotid, carotid artery, artery (Clic here for more details about this article) |
6/80. stroke in a healthy 46-year-old man.This article presents the case of a healthy 46-year-old man who experienced a dissection of the internal carotid artery. The diagnosis of this condition is not usually clear-cut, especially in a young patient with unremarkable medical history, and because of the similarity of symptoms with migraine. Often there is no obvious cause of a cerebral artery dissection, although subtle abnormalities of connective tissue may be present. Anticoagulation is generally used for therapy, but clinical trials are lacking. Carotid artery dissection should be considered as a cause of stroke in young healthy adults.- - - - - - - - - - ranking = 0.28740635924723keywords = carotid, carotid artery, artery (Clic here for more details about this article) |
7/80. Sympathetic paraganglioma as an unusual cause of Horner's syndrome.BACKGROUND: Paragangliomas are rare tumors arising from paraganglionic tissue of neural crest origin. They are present in any location where autonomic ganglia are found. The most common location in the head and neck is the carotid body, followed by the jugular bulb and vagus nerve. methods: A 30-year-old woman with a slowly growing left neck mass, aniscoria, and left eyelid ptosis was found to have a vascular tumor consistent with a paraganglioma arising near the left carotid bifurcation. After preoperative embolization, the patient underwent resection of the tumor. RESULTS: The tumor was found to be arising from the left sympathetic trunk and did not involve any other surrounding structures. Histopathologic analysis revealed the typical findings of a paraganglioma. CONCLUSIONS: Sympathetic paragangliomas are exceedingly rare tumors in the head and neck and should be considered in the differential diagnosis when clinical and radiographic evidence suggest a paraganglioma. The presentation is typically a slow-growing neck mass with the presence of an ipsilateral Horner's syndrome.- - - - - - - - - - ranking = 0.28667935153565keywords = carotid (Clic here for more details about this article) |
8/80. Spontaneous internal carotid artery dissection with lower cranial nerve palsy.BACKGROUND: Typical presentation of spontaneous internal carotid artery (ICA) dissection is an ipsilateral pain in neck and face with Horner's syndrome and contralateral deficits. Although rare, lower cranial nerve palsy have been reported in association with an ipsilateral spontaneous ICA dissection. CASE STUDIES: We report three new cases of ICA dissection with lower cranial nerve palsies. RESULTS: The first symtom to appear was headache in all three patients. Examination disclosed a Horner's syndrome in two cases (1 and 2), an isolated XIIth nerve palsy in two patients (case 1 and 3) and IX, X, and XIIth nerve palsies (case 2) revealing an ipsilateral carotid dissection, confirmed by MRI and angiography. In all cases, prognosis was good after a few weeks. CONCLUSIONS: These cases, analysed with those in the literature, led us to discuss two possible mechanisms: direct compression of cranial nerves by a subadventitial haematoma in the parapharyngeal space or ischemic palsy by compression of the ascending pharyngeal artery.- - - - - - - - - - ranking = 1.5619001506153keywords = carotid, carotid artery, artery (Clic here for more details about this article) |
9/80. Horner's syndrome after carotid endarterectomy--a case report.Horner's syndrome is described in a patient with anisocoria and unilateral lid ptosis 48 hours after an ipsilateral carotid endarterectomy. This case illustrates a rare iatrogenic complication of sympathetic nerve dysfunction following elective surgery.- - - - - - - - - - ranking = 0.71669837883913keywords = carotid (Clic here for more details about this article) |
10/80. Migraine and arterial dissection in a young woman.Ischemic stroke in young adults is rare (5%-10% of all ischemic strokes) and, in absence of other risk factors, may be associated with migraine. We describe the case of a 34-year-old woman, with a history of migraine without aura, who presented a sudden onset of headache with Horner's syndrome, and in whom neuroimaging showed evidence compatible with fibromuscular dysplasia (FMD) and arterial dissection of the extracranial internal carotid artery (ICA) and the carotid siphon. In our opinion, in young women with a long history of migraine, a careful study of the extracranial and intracranial arteries would be useful, although the cost/benefit ratio does not at present justify such a procedure. Our aim in the future is, therefore, to study a larger sample of migraine patients in order to find those patients who are most at risk of arterial dissection and who should, consequently, be carefully studied.- - - - - - - - - - ranking = 0.42664129692869keywords = carotid, carotid artery, artery (Clic here for more details about this article) |
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