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Review
. 2020 Dec 6:22:100304.
doi: 10.1016/j.ensci.2020.100304. eCollection 2021 Mar.

Treatment challenges in idiopathic extracranial ICA vasospasm case report and review of the literature

Edith Graham  1 , Karen Orjuela  1   2 , Sharon Poisson  2 , Jose Biller  1
Affiliations
Review

Treatment challenges in idiopathic extracranial ICA vasospasm case report and review of the literature

Edith Graham et al. eNeurologicalSci. .

Abstract

Idiopathic extracranial internal carotid artery (ICA) vasospasm is a rare pathological phenomenon that may lead to stroke in young patients. We report a case of an 18 year-old female with recurrent extracranial ICA vasospasm since age thirteen. We summarize published data related to this condition including all twenty-three reported cases of extracranial ICA vasospasm. We describe the various proposed pathophysiological mechanisms underlying this disorder. Various treatment modalities have been attempted but there is no known long-term effective treatment.

Keywords: Carotid artery diseases; Carotid stenosis; Migraine disorders; Stroke; Stroke and cerebrovascular diseases.

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Figures

Fig. 1
Fig. 1
CTA of the neck on admission (left) shows severe stenosis of the cervical segment of the right ICA. CTA of the neck three days later (right) shows recovery of the stenosis.
Fig. 2
Fig. 2
MRA at symptom onset age 13 (left) compared to MRA 3 weeks later (center) and MRA 3 months later (right). On the initial MRA, there is concentric right ICA stenosis just inferior to the skull base at C1 (Bouthillier classification). This short segment of stenosis is resolved in the center image, but there is new mild-to-moderate right ICA stenosis 2 cm above bifurcation a new moderate-to-severe left ICA stenosis at the inferior skull base and a separate area of milder left ICA stenosis just below. The MRA on the right is nearly normal except for very mild tapered narrowing on the right ICA above the bifurcation.
See this image and copyright information in PMC

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