Resolution

The radiologic hallmark of intramural dissection of the high cervical internal carotid artery is asymmetric stenosis of the vessel lumen, The region of stenosis is generally centered at the C1-C2 level of the cervical spine, although the length of involvement may be considerably longer. Spontaneous dissection occurs unilaterally and is usually unrelated to atherosclerotic changes in the involved vessel. When the patient survives the initial event and its accompanying neurologic deficit, this diagnosis can be deter-mined angiographically. This form of carotid artery dissection, occurring without pseudoaneurysm formation, generally resolves with conservation management. High cervical carotidopathy resulting in significant luminal stenosis poses a diifficult clinical problem, both in accurate diagnosis and treatment. The most common of such carotidopathies include atherosc lerosis, fibromuscular dyspla-sia, and direct trauma [1-4]. Spontaneous mural hemorrhage has also been reported as a cause of luminal stenosis and pseudoaneurysm format ion [15-26]. Angiographic opacification of either a false lumen or pseudoaneurysm requires disruption of the intima. However, when intimal integrity is preserved o