Internal carotid artery dissection associated with acute dengue virus infection: a case report / Dissecção da artéria carótida interna associada à infecção aguda pelo vírus da dengue: relato de caso

Cervical artery dissections (CAD) can occur spontaneously or as a direct result of significant trauma. Viral infections, such as SARS-CoV2, influenza, and Epstein Barr, are risk factors for spontaneous CAD. Dengue virus infections have dramatically increased in recent decades, and Brazil is one of the endemic areas. The dengue virus can cause headache and neurological complications such as encephalitis, myelitis, Guillain-Barré syndrome, and myositis. No report has yet been found in the literature of dissection of the internal carotid artery secondary to dengue infection. Our objective is to report the case of a patient with dissection of the internal carotid artery associated with acute dengue virus infection.

As dissecções da artéria cervical (DAC) podem ocorrer espontaneamente ou como resultado direto de trauma significativo. Infecções virais, como SARS-CoV2, influenza e Epstein Barr, são fatores de risco para DAC espontânea. As infecções pelo vírus da dengue aumentaram dramaticamente nas últimas décadas, e o Brasil é uma das áreas endêmicas. O vírus da dengue pode causar dor de cabeça e complicações neurológicas como encefalite, mielite, síndrome de Guillain-Barré e miosite. Ainda não foi encontrado na literatura nenhum relato de dissecção da artéria carótida interna secundária à infecção por dengue. Nosso objetivo é relatar o caso de um paciente com dissecção da artéria carótida interna associada à infecção aguda pelo vírus da dengue.

Clinical features and prognosis of anterior circulation cerebral Infarction secondary to cervical artery dissection / 中风与神经疾病杂志

@#Objective　To investigate the clinical features and prognosis of anterior circulation cerebral infarction secondary to cervical artery dissection.Methods　Sixty one patients with cervical artery dissection (CAD) secondary to anterior circulation cerebral infarction treated in Department of Neurology of North Jiangsu People’s Hospital from January 2016 to December 2020 were included consecutively.And 67 patients with large artery atherosclerosis (LAA) cerebral infarction complicated with moderate to severe carotid artery stenosis who were hospitalized at the same time were enrolled for comparison.The clinical data and prognosis between the two groups were compared.Results　Unifactorial analysis showed that the average age of CAD cerebral infarction group was younger,the incidence of head and neck pain and monocular amaurosis was higher,the proportion of massage trauma fatigue history was higher,the incidence of hypertension and smoking history was higher in LAA cerebral infarction group.The comparison of the two hematologic examinations showed that the erythrocyte count was higher in the CAD cerebral infarction group,and the D-dimer,cholesterol,glycated hemoglobin,and uric acid values were higher in the LAA cerebral infarction group.Binary logistic regression analysis showed that the history of massage trauma fatigue was more correlated with CAD cerebral infarction,while older age and smoking history were more correlated with LAA cerebral infarction.The improvement of NIHSS scores during hospitalization in the CAD cerebral infarction group was more significant than that in the LAA cerebral infarction group,and the difference was statistically significant.There were no significant differences in 90 day prognosis,mortality,and reinfarction rate within 6 months between the two groups.Conclusion　The correlation between the history of massage trauma and fatigue and CAD cerebral infarction was greater,and the correlation between the older age and smoking history and LAA cerebral infarction was greater.The improvement of NIHSS score in CAD cerebral infarction group during hospitalization was more obvious than that in LAA cerebral infarction group,which was statistically significant.There were no significant differences in 90 days prognosis,mortality and 6 month reinfarct rate between the two groups.