Unilateral dissection of the cervical portion of the internal carotid artery and ipsilateral multiple cerebral infarctions caused by suicidal hanging: a case report

• Published in: Nō shinkei geka Vol. 24; no. 9; p. 853
• Main Authors: Ikenaga, T, Kajikawa, M, Kajikawa, H, Yamamura, K, Wakabayashi, C, Sumioka, S, Furuse, M, Nomura, E, Yamaguchi, S
• Format: Journal Article
• Language: Japanese
• Published: Japan 01.09.1996
• Subjects: Carotid Artery Diseases - etiology; Carotid Artery Injuries; Cerebral Infarction - etiology; Constriction, Pathologic; Humans; Male; Middle Aged; Suicide, Attempted
• ISSN: 0301-2603

This paper presents a case of traumatic dissection of the unilateral internal carotid artery of the cervical portion caused by hanging. A 63-year-old man attempted suicide by hanging and was rescued immediately after. No neurological deficits were detected for the first 4 hours. But then, right hemiplegia, aphasia and disturbed consciousness suddenly developed. On the 2nd day, MRI revealed multiple infarctions in the left cerebral hemisphere. MR angiography demonstrated severe stenosis at the cervical portion of the left internal carotid artery due to dissection. The left middle cerebral artery was not demonstrated. The patient was conservatively treated with fibrinolytic agents and regained consciousness gradually. But aphasia and right hemiplegia remained. During the next few weeks, the stenosis at the ICA slightly improved and the MCA was completely recanalized. Extracranial Doppler sonography revealed chronological hemodynamic changes of mean flow velocity and pulsatility index at the proximal and distal portion of the ICA stenosis.