Spontaneous Arterial Dissection Secondary to Graves’ Disease: A Possible Association
Abstract
Arterial dissection is one of the common etiologies of young ischemic strokes. We report a case of Graves’ disease presenting as isolated spontaneous cervical internal carotid artery dissection followed by subarachnoid haemorrhage. A young female in her early 40s presented with 3-day history of headache and left hemiparesis. MRI of the Brain showed acute right hemispheric watershed infarcts. CT Angiogram showed a short segment right cervical internal carotid artery dissection. Her serum TSH was markedly reduced with an elevated free T3/free T4 ratio (1.78) and strongly positive Anti TSH-R antibodies. She was treated with anticoagulants and antithyroid medications. Still, later she developed an episode of focal seizure following right frontal subarachnoid hemorrhage, when anticoagulation was stopped and started on a single antiplatelet, with which she recovered well. Spontaneous cervical internal carotid artery dissection and focal subarachnoid haemorrhage presenting secondary to Graves’ disease without any other symptomatic systemic manifestations of hyperthyroidism is probably rare.
This work is licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License.
When publishing with Kerala Medicial Journal (KMJ), authors retain copyright and grant the journal right of first publication with the work simultaneously licensed under a Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license that allows others to share the work with an acknowledgement of the work's authorship and initial publication in this journal. Work includes the material submitted for publication and any other related material submitted to KMJ. In the event that KMJ does not publish said work, the author(s) will be so notified and all rights assigned hereunder will revert to the author(s).
The assignment of rights to KMJ includes but is not expressly limited to rights to edit, publish, reproduce, distribute copies, include in indexes or search databases in print, electronic, or other media, whether or not in use at the time of execution of this agreement.
Authors are able to enter into separate, additional contractual arrangements for the non-exclusive distribution of the journal's published version of the work (e.g., post it to an institutional repository or publish it in a book), with an acknowledgement of its initial publication in this journal.
The author(s) hereby represents and warrants that they are sole author(s) of the work, that all authors have participated in and agree with the content and conclusions of the work, that the work is original, and does not infringe upon any copyright, propriety, or personal right of any third party, and that no part of it nor any work based on substantially similar data has been submitted to another publication.
