{"pk":21189,"title":"Left, Then Right Internal Carotid Artery Dissection: A Case Report","subtitle":null,"abstract":"<p><strong>ABSTRACT</strong></p>\n<p><strong>Introduction</strong><br>We present a unique case report of a patient who presented to the emergency department<br>with stroke-like symptoms found to have a spontaneous left sided internal carotid artery<br>dissection. <br><strong>Case Report</strong><br>The patient was treated successfully with thrombectomy, and subsequently developed<br>contralateral symptoms caused by a right sided internal carotid artery dissection. This was<br>managed with a second contralateral thrombectomy.  The patient’s course was complicated by<br>persistent and mild hypotension, postulated to be secondary to bilateral carotid baroreceptor<br>trauma from the dissections. <br><strong>Conclusion</strong><br>This case highlights the importance of close neurological monitoring for patients,<br>preferably in a neurologic critical care setting, during and after invasive treatments such as<br>systemic thrombolytic administration or mechanical thrombectomy, as identifying the patient’s<br>subsequent development of contralateral symptoms in a timely fashion was key to his positive outcome.  An additional factor which had a positive impact on this outcome was the use of the RAPID Artificial Intelligence software which assists in determining whether thrombectomy may<br>be indicated prior to receiving a formal radiologist read on CT angiography/perfusion studies. <br>AI technologies such as this have a great potential to augment and expedite patient care.</p>","language":"eng","license":{"name":"Creative Commons Attribution 4.0","short_name":"CC BY 4.0","text":"Attribution — You must give appropriate credit, provide a link to the license, and indicate if changes were made. You may do so in any reasonable manner, but not in any way that suggests the licensor endorses you or your use.\r\n\r\nNo additional restrictions — You may not apply legal terms or technological measures that legally restrict others from doing anything the license permits.","url":"https://creativecommons.org/licenses/by/4.0"},"keywords":[{"word":"stroke"},{"word":"carotid dissection"},{"word":"Automated Intelligence"},{"word":"case report"},{"word":"automated intellegence"}],"section":"Case Reports","is_remote":true,"remote_url":"https://escholarship.org/uc/item/5fr4n7pg","frozenauthors":[{"first_name":"Jeffrey","middle_name":"M","last_name":"Kalczynski","name_suffix":"","institution":"Morristown Medical College, Department of Emergency Medicine, Morristown, New Jersey","department":""},{"first_name":"John","middle_name":"","last_name":"Douds","name_suffix":"","institution":"Sidney Kimmel Medical College, Philadelphia, Pennsylvania","department":""},{"first_name":"Michael","middle_name":"E","last_name":"Silverman","name_suffix":"","institution":"Morristown Medical College, Department of Emergency Medicine, Morristown, New Jersey","department":""}],"date_submitted":"2024-07-08T18:51:40.787000Z","date_accepted":"2024-09-05T17:11:49.552000Z","date_published":"2024-10-23T07:00:00Z","render_galley":null,"galleys":[{"label":"PDF","type":"pdf","path":"https://journalpub.escholarship.org/uciem_cpcem/article/21189/galley/30161/download/"}]}