A 52-year-old woman with no prior migraine history presents with sudden-onset severe frontal headache, neck stiffness, and left-sided weakness. Vital signs: BP 156/92 mmHg, HR 98/min, RR 16/min, temp 37.2°C, SpO2 98% on room air. MR angiography demonstrates right carotid artery dissection with 80% stenosis and intimal flap. Serum glucose is 105 mg/dL. Which mechanism best explains ischemic stroke development in carotid dissection?
- A)Increased intracranial pressure from venous outflow obstruction
- B)Arterial rupture causing hemorrhagic transformation
- C)Thromboembolism from the dissected vessel and/or flow-limiting stenosisGABARITO
- D)Transient hypoxia from global hypoperfusion
- E)Acute vasospasm of the carotid artery
Explicação
Carotid artery dissection causes stroke through two mechanisms: (1) thromboembolism from the intimal flap and intramural hematoma, and (2) hemodynamically significant stenosis reducing distal perfusion. Both can occur simultaneously in significant dissections. Ver explicação completa e trilha adaptativa →