Anticoagulation and microembolus detection in a case of internal carotid artery dissection

Sebastian Koch, Jose G. Romano, Iszet Campo Bustillo, Mauricio Concha, Alejandro M. Forteza

Research output: Contribution to journalArticlepeer-review

9 Scopus citations


Background. Microembolic signals (MES) have been demonstrated by transcranial Doppler (TCD) in cases of internal carotid artery dissection. The influence of treatment on MES in arterial dissection is uncertain. The authors here present a case of internal carotid artery dissection in which we detected a reduction of MES after the initiation of intravenous heparin. Methods. A 37-year-old woman developed a right temporal headache 10 days prior to admission. This was followed by episodes of left arm numbness and weakness. Magnetic resonance imaging (MRI) showed a right frontal and deep subcortical ischemic infarct. Catheter angiography confirmed a right internal carotid artery dissection with intracranial extension. She was then monitored with TCD for MES before and after intravenous heparin was started. Results. The first TCD, performed 12 days after symptom onset, showed 39 MES during 60 minutes of insonation of the right middle cerebral artery. Treatment with intravenous heparin resulted in a decline in MES by 50% after 96 hours. This decline continued and no further MES were detected after 11 days of anticoagulation. Conclusion. The authors were able to demonstrate a decline of MES with heparin anticoagulation in a case of internal carotid artery dissection.

Original languageEnglish (US)
Pages (from-to)63-66
Number of pages4
JournalJournal of Neuroimaging
Issue number1
StatePublished - Jan 1 2001


  • Anticoagulation
  • Arterial dissection
  • Embolus detection
  • Transcranial Doppler

ASJC Scopus subject areas

  • Radiology Nuclear Medicine and imaging
  • Clinical Neurology
  • Neuroscience(all)
  • Radiological and Ultrasound Technology


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