Internal carotid artery dissection

Case contributed by Mariia Anisimova
Diagnosis almost certain


Acute right sided neck pain

Patient Data

Age: 35 years
Gender: Female

In the longitudinal and transverse projections, the abnormal internal carotid artery can be seen. There are no normal ultrasound findings of internal carotid artery. The walls of the artery are very thickened with vessel expansion to 1,09 cm and stenosis of channel blood flow to 0,24 cm. In the doppler image, increased velocity to 274 cm/s is consistent with hemodynamically significant stenosis of the artery.

Case Discussion

This case demonstrates typical ultrasound appearance of carotid artery dissection. It is an example of ultrasound findings which are often difficult to see. 

The differential for these findings is atherosclerotic degeneration, but age and clinical symptoms of the patient are more typical for dissection.

MRI was used to confirm the diagnosis, which confirmed intramural hematoma on T1 fat saturated sequences (not shown).

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