Introduction:

dissection of the internal carotid artery in patients who suff ered an ischemic stroke is increasingly being diagnosed. In young adults it represents 20-25 %. no consensus has been established regarding diagnosis and treatment.

Case report:

a 44-year-old man presented a sudden headache with motor and sensory defi cits in the left upper limb after doing physical exercise. on the MrI scan revealed an infarction in the right middle cerebral artery with a hemorrhagic transformation. CT angiography of the supra-aortic trunks showed a thrombosed hematoma in the false lumen of the right internal carotid dissection. The patient made a spontaneous recovery. at fi rst, we maintained a conservative attitude but after one year of monitoring, there was progression of the hematoma producing a steno- sis > 75 % of the right internal carotid artery. at this point it was decided to implant an uncovered stent at this level.

Discussion:

early diagnosis and treatment of carotid dissection makes possible preventing disabling neurological sequelae. In patients with carotid dissection it is recommended a biannual monitoring with a doppler ultrasound during the fi rst years.

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