RICA dissection, posttraumatic
Findings:
RAO and lateral right common carotid arteriograms show
a linear filling defect in the cervical ICA, consistent with a flap. There
is mild tapered stenosis at the level of the flap.
Discussion:
Arterial dissection is a relatively common injury seen
in high speed deceleration injuries, with common association of cervical
spine injuries. Dissection is usually treated with anticoagulation if there
is no contraindication, and the majority of dissections either remain stable
or resolve. Few dissections progress to complete occlusion, and this is
usually seen on the initial arteriogram. Dissections are common just below
the skull base where there is increased shear force. Dissection may occur
with relatively minor trauma, and vessel kinks may predispose to dissection.