부산대학교 도서관

We report a case of internal carotid artery dissection caused by seat belt injury, successfully treated with endovascular surgery. A man in his 50s was involved in accidents when he was driving his car. His right mandible, neck and shoulder were compressed by the seatbelt at that time. He felt continuous pain in his mandible, neck and shoulder, then consulted an orthopedic surgeon but no abnormal finding was pointed out. Four days later, in the morning he transferred to our hospital due to headache. Head computed tomography (CT) showed no intracranial traumatic lesion, then he returned to home. However, in the evening he was again transferred to our hospital due to left hemiparesis. Magnetic resonance imaging (MRI) demonstrated acute ischemic lesion on right cerebral hemisphere, and MR angio­graphy (MRA) revealed right internal carotid artery occlusion. Emergent cerebral angiography showed right internal carotid artery dissection and right middle cerebral artery occlusion. Endovascular thrombectomy and carotid artery stenting was performed. Postoperative course was uneventful. He discharged with no abnormal neurological deficit. Delayed presentation of seat belt injury is rare, but we should keep in mind that serial follow–up by MRI or CTA would reveal eventual change of carotid artery even if it is asymptomatic.