A spontaneous carotid artery dissection in a ballet dancer ; A case report

摘要: Introduction: Cervicocerebral arterial dissections (CAD) account for nearly 20% of strokes in patients under the age 45, therefore they are an important cause stroke young adults. Most CADs considered ‘spontaneous’, although pre-existing disorders wall and trauma main predisposing factors. It is to recognise treat this syndrome because a relatively benign course potentially excellent outcome most patients. We describe case where definite temporal correlation was present between neck movement, trivial acute dissection. Case report: 48-year old professional male ballet dancer with spontaneous right internal carotid artery dissection presented as transient leftsided weakness, right-sided tinnitus blurry vision his eye, following intense jerky head movements during dancing. The initial neurological examination revealed side Horner syndrome. CT negative. He subsequently admitted Stroke unit referred color Doppler flow imaging revealing subintimal hematoma proximal part reverse ophthalmic artery. Transcranial doppler showed markedly reduced hemodynamic middle cerebral Head MRI multiple ischemic lesions (emboli) frontal regions, basal ganglia, external capsule knee capsule. MR angiography narrowing stenosis artery, pathological morfological changes from bifurcation intracranial beneath pyramid, suggestive Laboratory findings hyperlipidemia elevated liver enzymes. patient treated antiplatelet, antihypertensive hypolipidemic agents, well physical therapy. After hospital discharge, ultrasound follow-up 14 days after through outpatient clinic persistence hematoma, but blood all studied arteries now physiological. At five-month follow-up, unremarkable except slight eyelid ptosis. Carotid complete resorption physiological hemodynamics arteries. Conclusion: There seems be association movements, minor non-penetrating torsion precipitating Whether `spontaneous' truly or effect forgotten indirect questionable. A review literature shows that many 'spontaneous' dissections, history abnormal exercise present. such subtle events should taken while diagnosing stroke. Sometimes causal potential antecedates immediately symptoms there definitive correlation, sometimes onset may precede clinical by hours it might loosen two. Hyperextension has been factor, particularly presence inherent vessel abnormalities. By early identification treatment, high-risk patients, possible reduce incidence secondary noninvasive, accessible prompt method central role assessment midcervical dissections.