A typically progressive dissection of the internal carotid artery with recurrent hiccups: A case report with continuous 2‐year data recording. Issue 1 (9th November 2022) - Zhang, Zong‐Min
Abstract: Patients with internal carotid artery dissection (ICAD) usually report headache, neck pain, Horner's syndrome, and ischemic stroke. Because the posterior cranial nerve is involved, some patients may show different forms of posterior cranial nerve paralysis. There have been no reports of patients with ICAD showing repeated hiccups. Here, to help clinicians identify ICAD early and gain a better understanding of the atypical manifestations of the disease, we report an atypical case of recurrent hiccup symptoms caused by ICAD. Abstract : The dissection of the internal carotid artery resulted in an intermural hematoma, which resulted in stenosis of the vascular lumen and the shedding of the thrombi, resulting in symptoms of ischemic stroke; this is a common clinical manifestation. Some patients may present with different forms of posterior cranial nerve palsy due to the involvement of the posterior cranial nerves. There have been no reports of symptoms of repeated hiccups. The vagus nerve is in close contact with the internal carotid artery in the carotid sheath, when ICAD occurs, it may affect the adjacent vagus nerve. Sandwich intramural hematoma may lead to the expansion of the blood vessel lumen to stimulate the vagus nerve, and especially when the neck is rotated, the vagus nerve is further pulled and stimulated, resulting in repeated hiccups. Hiccups are probably an atypical presentation of internal carotid artery dissection that should be a concern for clinicians.