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Rehabilitation Practice and Science

Translated Title

無明顯頸部挫傷之創傷性內頸動脈剝離致腦梗塞：病例報告

Abstract

A 37-year-old female had an occlusion of right middle cerebral artery (MCA) due to traumatic internal carotid artery (ICA) dissection without significant neck injury after a traffic accident. Although this phenomenon has been documented in recent studies, it remains a relatively rare event. She presented with a left shoulder abrasion injury and mild neck pain initially, although there was no direct head injury or loss of consciousness after the traffic accident. After 12 hours, she had developed confusion, weakness over left limbs and slurred speech. A hyperdense area on the right frontotemporoparietal lobes was found on magnetic resonance imaging (diffusion-weighted imaging). The infarct of the right M1 segment of the MCA was confirmed with magnetic resonance imaging and magnetic resonance angiography. An atherosclerotic plague and dissection in her right ICA were also found after Doppler examination. Craniectomy was performed on the next day after the accident due to the severe brain edema. After six months of rehabilitation, her functional status progressively improved. This casereport reminds clinicians that delayed cerebral infarction could occur following an accident of cervical stretching with ICA injury, especially in patients with carotid atherosclerosis, and a Doppler examination of carotid artery is a good screening tool to detect the dissection.

Language

English

First Page

233

Last Page

238

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