A novel treatment for symptomatic carotid dissection

Carotid dissection is a rare but significant cause of stroke. The neurological damage in such cases is mainly attributable to thromboembolism.1 Current treatment includes supportive therapy and antiplatelet agent either alone or with anticoagulation. This is not supported by randomised trials2 but it is logical. Presence of microemboli in cerebral circulation is a risk factor for ischaemic stroke after transient ischaemic attack (TIA)3 and transcranial Doppler examination (TCD) can detect them in middle cerebral artery circulation.4 Controlling microemboli improves the outcome in recurrent TIA and after carotid endarterectomy.5,6 We found this strategy effective in the treatment of a symptomatic carotid dissection unresponsive to anticoagulation. We report a case of carotid artery dissection treated successfully by controlling microemboli from the dissected artery and discuss its validity