{
  "abstract": "Background Multiple vascular dissections without genetic predisposition or connective tissue disorder is scarcely reported. We report a case of multiple large and intermediate vessel spontaneous dissections likely secondary to a transient inflammatory generalized vasculopathy.Methods Case Report.Results A 59-year-old male was referred with a 2-week history of severe left hemicranial throbbing headache associated with transient right leg weakness. CT angiogram (CTA) revealed bilateral internal carotid artery dissections with high grade stenosis. There was no antecedent trauma, neck manipulation or vascular risk factors. He denied infectious or constitutional symptoms, visual loss, jaw claudication or arthralgia.CTA of neck and thoracoabdominal aorta revealed interval development of asymptomatic right subclavian and right renal artery dissections. There was no circumferential vascular thickening.FDG PET showed widespread uptake, including in arteries unaffected by dissection. Systemic inflammatory markers were elevated. Vasculitic and infective blood screens and temporal artery biopsy were negative. CSF was bland with negative VZV DNA PCR.He continued aspirin and remained without neurological deficit. On 3-month follow-up inflammatory markers normalized and repeat imaging showed improvement in dissections. Repeat PET demonstrated only mild residual right subclavian artery uptake. Genetic work up was negative.Conclusion Multiple simultaneous arterial dissections with evidence of inflammation on PET and raised inflammatory markers is suggestive of a transient inflammatory arteritis. Aetiology could be transient infection or post infective immune mechanism causing an increased risk of spontaneous dissection. This should be a diagnosis of exclusion after meticulously ruling out other causes for arteritis and multiple spontaneous arterial dissections.",
  "authors": [
    {
      "affiliations": [
        "Sir Charles Gairdner Hospital, Perth, WA, Australia"
      ],
      "name": "Sharanya Shanmugakumar"
    },
    {
      "affiliations": [
        "Sir Charles Gairdner Hospital, Perth, WA, Australia"
      ],
      "name": "Thomas Chemmanam"
    },
    {
      "affiliations": [
        "Sir Charles Gairdner Hospital, Perth, WA, Australia"
      ],
      "name": "Muhammad Zubair"
    }
  ],
  "title": "3501 Dissecting the dissections: a case of multiple spontaneous arterial dissections",
  "uid": "2f6d7680-3bce-591b-8ee1-fdf7e08d8c88"
}