Unusual manifestations of bilateral carotid artery dissection: Dysphagia and hoarseness.

Dissection of the carotid artery can occur intracranially or extracranially, although dissections tend to affect extracranial segments of the arteries much more commonly than intracranial segments. Carotid artery dissection (CAD) is most common in middle-aged women. Although not completely known, the main risk factors related to carotid artery dissection are genetic and environmental factors, traumatic events, cervical manipulation, migraine, recent infections, hyperhomocysteinemia, and hereditary connective tissue disorders. Although some cases of bilateral internal CAD have been reported, spontaneous bilateral dissections are rare. Prolonged hoarseness is usually due to using the voice either too much, too loudly, or improperly over an extended period of time. Disorders leading to dysphagia may affect the oral, pharyngeal, or esophageal phases of swallowing. In this study we report on a patient with bilateral CAD who presented to our clinic with dysphagia and hoarseness.