This Article Full Text Full Text (PDF) Alert me when this article is cited Alert me if a correction is posted Services Email this article to a friend Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Download to citation manager Request Permissions Citing Articles Citing Articles via HighWire Citing Articles via Google Scholar Google Scholar Articles by Arning, C. Articles by Lachenmayer, L. Search for Related Content PubMed PubMed Citation Articles by Arning, C. Articles by Lachenmayer, L. Pubmed/NCBI databases Medline Plus Health Information Carotid Artery Disease Transient Ischemic Attack

(Stroke. 1998;29:1063-1066.)
© 1998 American Heart Association, Inc.

Case Report

Cervical Carotid Artery Vasospasms Causing Cerebral Ischemia

Detection by Immediate Vascular Ultrasonographic Investigation

Christian Arning, MD; Alexandra Schrattenholzer, MD; Lutz Lachenmayer, MD

From the Department of Neurology, Barmbek Hospital, Hamburg, Germany.

Correspondence to Dr Christian Arning, Abteilung Neurologie, Allgemeines Krankenhaus Barmbek, D-22291 Hamburg, Germany. E-mail christian.arning{at}t-online.de

Background—The etiology of cerebral ischemic accidents in young adults often remains unclarified.

Case Description—A 32-year-old woman presented after multiple episodes of left monocular visual impairment and right-sided focal signs. MRI revealed a low-flow infarction on the left; color-coded duplex sonography (CCDS), however, showed normal vascular findings. During the inpatient rehabilitation, a renewed visual impairment occurred; an immediate CCDS examination now demonstrated a filiform stenosis of the left internal carotid artery (ICA) 4 cm above the origin and indirect signs of a severe stenosis of the right ICA. Results of a follow-up examination 18 hours later were again normal. Six weeks later, on reoccurrence of visual impairment, a reversible stenosis of the left ICA was again demonstrated. A search for possible causes of vasospasm was unsuccessful. After treatment with calcium antagonists the patient was free of complaints (with the exception of 3 very short attacks of visual impairment) during the following 12 months.

Conclusions—Cervical carotid artery vasospasms can apparently occur spontaneously without a mechanical trigger. Because their detection is difficult, vasospasms may go undetected.

Key Words: carotid arteries • cerebral ischemia • ultrasonics • vasospasm • young adults

This article has been cited by other articles:

				W. G. Janzarik, P. A. Ringleb, M. Reinhard, and S. Rauer Recurrent Extracranial Carotid Artery Vasospasms: Report of 2 Cases Stroke, August 1, 2006; 37(8): 2170 - 2173. [Abstract] [Full Text] [PDF]

				D. H. Benninger, D. Georgiadis, J. Gandjour, and R. W. Baumgartner Accuracy of Color Duplex Ultrasound Diagnosis of Spontaneous Carotid Dissection Causing Ischemia Stroke, February 1, 2006; 37(2): 377 - 381. [Abstract] [Full Text] [PDF]