Clinical manifestation of internal carotid artery dissection: stages of diagnostic search

   Dissection of the internal carotid artery (ICA) is a common cause of ischemic stroke in young patients without cardiovascular risk factors and is artery wall defect that can lead to stenosis and even occlusion of the artery. There is an obvious need for a systematic approach to analyzing the causes of cerebral circulatory disorders in young patients, including the combined use of ultrasound (US) and CT angiography when diagnosing dissection of the internal carotid artery. The article presents a description of a clinical observation of spontaneous dissection of the internal carotid artery in a 45-year-old patient, the isolated manifestation of which was Horner’s syndrome, its step-by-step diagnosis, as well as a brief review of the literature on this topic. Early initiation of treatment ensured stabilization of the patient’s condition and a favorable outcome in the form of good functional recovery, spontaneous resolution of the intramural hematoma and remodeling of the internal carotid artery with a decrease in the degree of its stenosis a week after the start of treatment according to ultrasound. Thus, contrast research methods and ultrasound are complementary stages of the diagnostic search.

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