Surgical Position, Cause of Extracranial Internal Carotid Artery Dissection, Presenting as Pourfour Du Petit Syndrome: Case Report and Literature Review

• Published in: Turkish neurosurgery Vol. 25; no. 4; pp. 666 - 669
• Main Authors: Villalba Martinez, Gloria, Navalpotro Gomez, Irene, Serrano Perez, Laura, Gonzalez Ortiz, Sofia, Fernández-Candil, Juan L, Steinhauer, Eva Giralt
• Format: Journal Article
• Language: English
• Published: Turkey 2015
• Subjects: Adult; Carotid Artery, Internal, Dissection - etiology; Craniotomy - methods; Diabetes Mellitus, Type 1 - complications; Female; Horner Syndrome - etiology; Horner Syndrome - therapy; Humans; Neck; Neurosurgical Procedures - adverse effects; Patient Positioning - adverse effects; Postoperative Complications - etiology; Stroke - complications; Subarachnoid Hemorrhage - etiology; Vasospasm, Intracranial - etiology; Vasospasm, Intracranial - therapy
• ISSN: 1019-5149
• DOI: 10.5137/1019-5149.JTN.10155-13.1

Dissection of the internal carotid artery is a rare cause of stroke overall, but causes 22% of strokes in younger patients. A common clinical presentation is as Claude Bernard Horner syndrome. We report a craniotomy with 30 degrees rotation of the neck (standard position) in a patient with no major risk factors for carotid dissection, who showed a Pourfour du Petit syndrome due to a dissection of the internal carotid artery. To the best of our knowledge, this is the first reported case in which a common surgical position causes an internal carotid artery dissection in a patient without relevant risk factors. The presentation with Pourfour du Petit syndrome is extremely unusual.