Evaluation of Patients with Internal Carotid Artery Dissection in Emergency Service

Songür Kodik M. , Kıyan G. S.

6. Avrasya Acil Tıp Kongresi& 14. Türkiye Acil Tıp Kongresi, Antalya, Turkey, 08 November 2018, pp.685

  • Publication Type: Conference Paper / Summary Text
  • City: Antalya
  • Country: Turkey
  • Page Numbers: pp.685


Evaluation of Patients with Internal Carotid Artery Dissection in Emergency Service   Meltem Songür Kodik, Güçlü Selahattin Kıyan Ege Üniversitesi, Acil Tıp Anabilim Dalı, İzmir   Introduction: The most significant cause of ischemic stroke in all age groups is; carotid artery dissection. It occurs frequently in fifth decade, and also responsible a large percentage of strokes in younger age group. The Eagle syndrome which can be associated with elongation of styloid is a rare condition and may occur with Internal Carotid Artery (ICA) dissection. The purpose of this study is to assess clinical presentations, lesion locations on Computed Tomography (CT), CT angiography, Magnetic Resonance Imaging (MRI) of patients with internal carotid artery dissection and Eagle syndrome. 


Method: The authors identified 16 patients admitted to their emergency department with variable neurological symptoms and had a definite diagnosis of ICA dissection between April 2011 - April 2018 and 5 of these patients diagnosed as Eagle Syndrome. All the patients underwent unenhanced cranial CT, cranial / neck CT angiography and Magnetic Resonance Imaging. There after consulted to neurology. 


Findings: We studied 16 cases retrospectively, consisting of 8 males and 8 females. Among the patients, 8 of them had right ICA dissection, 6 of them had left ICA dissection and 2 of them had no dissection on CT angiography. At the 14 of these patients on the site of dissection on CT and MRI there were findings compatible with acute infarction. After neurology consultation 13 patients were hospitalized, 3 patients were discharged.  


Conclusion: An increasingly recognized cause of ischemic strokes in young adults is ICA dissection. The compression of internal or external carotid artery which is named stylo carotid syndrome is the second form of Eagle syndrome. For all of these patients with clinical suspicion, emergency physician should be aware of ICA dissection and this should be screened with CT, CT angiography or MRI.   Keywords: Internal carotid artery dissection, eagle syndrome, computed tomography angiography