Unusual condition discussed today - spontaneous dissection of the carotid artery resulting in stroke in a young patient. Often precipitated by an innocuous trauma such as turning the head rapidly, painting a ceiling, extending the neck during hair care at a beauty shop, and chriopractic manipulation (risk probably less than 1 in 40,000 encounters).
Collagen vascular disease present in ~ 1/4 as a predisposing cause.
This article from NEJM is a comprehensive review of the topic and covers vertebrobasilar (which has a similar pathogenesis and treatment) dissection as well.
Treatment is anticoagulation with heparin followed by warfarin, and interventions such as stenting is generally reserved for those with unresolving neuro deficits or significant hemodynamic cerebral blood flow impairments.
Review of topics covered in morning report, M&m, and core conferences with links to supplemental reading material.
Subscribe
Posts
Comments
No comments:
Post a Comment