A Case of Spontaneous Dissection of the Extracranial Internal Carotid Artery

This report presents a rare case in which carotid stenting was performed to treat spontaneous dissection of the internal carotid artery (ICA). A 35-year-old man presented with right hemiparesis and aphasia. Magnetic resonance imaging depicted fresh multiple infarctions in the left cerebral hemisphere with left ICA occlusion. The patient was placed on bed rest and medical therapy. However, magnetic resonance imaging and computed tomography angiography 6 weeks after the admission revealed that the extracranial carotid artery aneurysm progressively increased in size. Stenting was performed under local anesthesia and distal protection. The implementation of one Wallstent improved both ICA morphology and cerebral blood flow. Progressive thrombosis gradually occurred, and the aneurysm disappeared on computed tomography angiograms 1 month after stenting. The flow change caused by the stent may have led to thrombosis and healing of the aneurysm in this case. This report presents this rare case along with a literature review of the clinical profile and related neuroimaging findings, as well as a discussion of the treatment and outcomes of similar cases.