Abstract
We report the case of a young woman affected by an aneurysmal subarachnoid haemorrhage (SAH) and numerous anatomic abnormalities. A Transcranial Colour-Coded Duplex Sonography, performed with the aim of monitoring the vasospasm, showed a non-pulsatile flow with loss of sharp systolic peak and lowering of mean flow velocities in the right extracranial Internal Carotid Artery (ICA) and all its intra-cranial branches. This event suggested a possible concomitant acute right ICA sub-occlusion with a lack of collateral circulation. This type of flow is typically found in systemic and brain arteries of patients undergoing to venous–arterial extracorporeal membrane oxygenation or to left ventricular assist devices. The absence of an adequate cerebral collateral circulation might be the explanation for this type of atypical flow. Aneurysms and arterial dissections contribute to SAH and ischemic stroke events, leading to long-term physical and cognitive disability. In our case, the prompt neurosonological diagnosis leaded to patient’s good outcome.
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FP collaborated in writing manuscript and searching references. IS, performed and interpreted Transcranial Color-Codex Sonography and collaborated to figures preparation. GF collaborated to figures preparation and interpreted Neuroimaging. SC, IMV and VB analysed, interpreted Neuroimaging, and collaborated to manuscript revisions. RT performed and interpreted Transcranial Color-Codex Sonography exams and gave the main contribution to manuscript preparation and revisions. All authors read and approve the final manuscript.
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Parodi, F., Severi, I., Flora, G. et al. Concurrent subarachnoid haemorrhage and internal carotid artery dissection: a transcranial colour-coded sonography diagnosis. J Ultrasound 26, 771–776 (2023). https://doi.org/10.1007/s40477-022-00686-z
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DOI: https://doi.org/10.1007/s40477-022-00686-z