Disección de arteria carótida interna secundario a accidente en motocicleta

Abstract

The traumatic dissection of the internal carotid artery can be secondary to iatrogenic, connective tissue disorders and less commonto trauma that causes the rupture of the intima either by direct contusion or various degrees of rotation or hyperextension of the neck. The clinical case corresponds to a 20-year-old male patient who suffers a motorcycle accident. Upon admission to hospitalization, the initial evaluation of the patient is stable, without neurological deficit. After 9 hours decrease in Glasgow, progressive swelling in the right-side neck and severe pain; Anangiotomography was performed with bleeding from the right vascular bundle and a decrease in the lumen of the ipsilateral internal carotid artery. A surgical procedure was performed for vascular exploration of the neck and correction of internal jugular vein laceration. Antiplatelet therapy is started. After 24 hours, he presented clinical and imaging data of an ischemic cerebrovascular event, wich required a decompressive craniectomy. After 48hours, a well-established infarction of the right middle cerebral artery territory secondary to embolism due to right carotid dissection on its bifurcation. After 7 days, he was discharged with long-term antiplatelet treatment.