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- W2247374410 abstract "OBJECTIVE: To describe a patient with bilateral carotid and vertebral artery dissections in the post-partum period following a cesarean section. BACKGROUND: Spontaneous multiple precerebral arterial dissection is extremely rare, especially in association with pregnancy. Previous reports of precerebral arterial dissection in the post-partum period were attributed to eclampsia and mechanical straining during vaginal delivery. We report a case of spontaneous dissection of the bilateral carotid and vertebral arteries occurred in a young woman following cesarean section in the absence of mechanical straining, trauma or hypertension. DESIGN/METHODS: Case report and review of the literature. RESULTS: A 29-year-old woman presented to the emergency department 2 weeks following an elective cesarean section with a sudden occipital headache, right-side numbness and weakness. Neurological examination revealed right Horner syndrome, mild right hemiparesis and hemianesthesia. Brain MRI revealed a small infarct in the right lower lateral medulla. Cerebral angiography revealed bilateral carotid pseudoaneurysm and vertebral arterial dissections without evidence of fibromuscular dysplasia or atherosclerosis. She was treated with antithrombotic (aspirin 325 mg daily). Cerebral angiography 3 months later showed significant improvement in blood flow in the carotid and vertebrobasilar systems with evidence of resolving pseudoaneurysms in the internal carotid arteries. Follow up after 6 months revealed complete resolution of the neurological symptoms. Similar to our patient, 7 reported cases of post-partum precerbral arterial dissections were associated with vaginal deliveries that had been attributed to the mechanical strain during child birth or eclampsia. One patient had intracranial angiopathy resemble a reversible vasoconstriction syndrome. Four patients treated with anticoagulation. Including our patient, outcome was favorable in all reported cases. CONCLUSIONS: Idiopathic multiple precerebral arterial dissection occurred in the post-partum period in the absence of eclampsia, mechanical strain, or vasoconstriction syndrome. Clinical and radiological outcomes are favorable in all reported cases. Disclosure: Dr. Allam has nothing to disclose. Dr. Alawi has nothing to disclose. Dr. Alshekhlee has nothing to disclose. Dr. Vora has nothing to disclose. Dr. Mehta has nothing to disclose." @default.
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- W2247374410 date "2013-02-12" @default.
- W2247374410 modified "2023-10-07" @default.
- W2247374410 title "Bilateral Carotid and Vertebral Artery Dissection Following Cesarean Section (PD7.007)" @default.
- W2247374410 hasPublicationYear "2013" @default.
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