Stroke in Patients with Common Carotid Artery Dissection Secondary to Dissecting Aortic Aneurysm: an Observational Vascular Imaging Study

BackgroundCommon carotid artery dissection (CCAD) usually arises from the extension of an aortic arch dissection. Neurologic complications, including stroke, sometimes occur in CCAD patients. We investigated the imaging characteristics of CCAD patients with and without stroke.Materials and MethodsFrom 1990 to 1999, there were eight patients diagnosed with CCAD, all due to aortic arch dissection. The clinical manifestations, findings of color-coded duplex sonography (CDS) and other vascular imaging modalities were analyzed.ResultsUltrasonographic study of all patients revealed a visible intimal flap dissecting the common carotid artery lumen into the true and false lumina. Three patients had cerebral infarctions and one had a transient ischemic attack. Two patients had thrombi in the false lumen of the common carotid arteries on CDS. Chest radiography showed thrombi in the aortas of two patients. One patient was proved to have aortic arch dissection after a stroke.ConclusionThrombi were noted in the false lumina of the common carotid arteries or aortas of all CCAD patients with stroke, but not in the patients without stroke. CDS can be used as an additional examination for the diagnosis and follow-up of patients with aortic dissection and CCAD