Severe Spontaneous Carotid Artery Dissection and Multiple Aneurysmal Dilatations

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Abstract
Spontaneous cervical artery dissections or arterial aneurysms associated with deficien cies of α1-antitrypsin (α 1-AT) or other inhibitors of proteolytic enzymes have occasion ally been reported. However, a coexistence of severe spontaneous internal carotid artery dissection and multiple aneurysmal dilatations associated with α1-AT phenotype M1S have not yet been presented; herein the authors describe such a patient. In order to avoid the risks associated with intraarterial angiography in a patient in whom an under lying arteriopathy is suspected, only noninvasive techniques were employed. This case demonstrates that magnetic resonance imaging combined with magnetic resonance angiography is a valuable noninvasive method for use in diagnosis and follow-up of carotid artery dissection.