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(Stroke. 2006;37:2170.)
© 2006 American Heart Association, Inc.

Case Reports

Recurrent Extracranial Carotid Artery Vasospasms

Report of 2 Cases

Wibke G. Janzarik, MD; Peter A. Ringleb, MD; Matthias Reinhard, MD Sebastian Rauer, MD

From the Departments of Neurology, University of Freiburg (W.G.J., M.R., S.R.), Freiburg, and Ruprecht-Karls University (P.A.R.), Heidelberg, Germany.

Correspondence to Wibke G. Janzarik, MD, Department of Neurology, University of Freiburg, Neurocenter, Breisacher Strasse 64, 79106 Freiburg, Germany. E-mail janzarik{at}nz11.ukl.uni-freiburg.de

Abstract

Background and Purpose— Spontaneous vasospasms of the submandibular internal carotid arteries are rarely observed. They are a highly dynamic process, recur frequently, and can be detected by serial ultrasound examinations.

Summary of Cases— We present 2 cases of recurrent extracranial vasospasms of the internal carotid artery as a cause of stroke. In both cases, arterial dissection was initially suspected, but no intramural hematoma was detected on magnetic resonance imaging. Duplex sonography demonstrated recurrent high-grade stenoses of both internal carotid arteries that resolved spontaneously within hours to days. The vasospasms were treated with calcium antagonists and in 1 patient with oral corticoids.

Conclusions— Extracranial vasospasms as a cause of stroke might be underestimated. Vasospasms of the internal carotid arteries should be considered in patients with recurring ischemic events in the absence of any other explanation. Antiphlogistic treatment in combination with calcium antagonists might be effective to reduce the frequency of vasospasms.

Key Words: internal carotid arteries • sonography • stroke, ischemic • vasospasm

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				R. K. Menon and J. Norris Recurrent Carotid Artery Vasospasm or Dissection? Stroke, May 1, 2007; 38(5): e16 - e16. [Full Text] [PDF]

				W. G. Janzarik, P. A. Ringleb, M. Reinhard, and S. Rauer Response to Letter by Menon and Norris Stroke, May 1, 2007; 38(5): e17 - e17. [Full Text] [PDF]