Ocular ischaemia due to a spontaneous carotid artery dissection

Sara Frazao, Catarina Perry da Câmara, Rita Pinto Proenca, Joana Tavares Ferreira

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3 Citations (Scopus)


Internal carotid artery dissection (ICAD) is caused by the disruption of the tunica intima, with the formation of an intramural haematoma that can cause stenosis or occlusion of the artery's lumen, leading to reduced blood flow and secondary thrombus formation. Up to two-thirds of patients with ICAD show ophthalmological symptoms or signs, which are, frequently, the first manifestations of this clinical condition, often preceding for weeks the neurological signs of cerebral infarction. Central retinal artery occlusion (CRAO) is a rare complication of ICAD, secondary either to haemodynamic compromise, with ocular hypoperfusion and reverse flow within the ophthalmic artery, or to thromboembolic events, in rarer cases. We report a case of CRAO secondary to a spontaneous ICAD, in an otherwise healthy middle-aged patient.

Original languageEnglish
Article numbere227952
JournalBMJ case reports
Issue number5
Publication statusPublished - 1 May 2019


  • Neuroimaging
  • Neuroopthalmology
  • Ophthalmology
  • Retina
  • Stroke


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