scholarly journals When the fat hits the brain—salvage STA–MCA bypass for an intracranial ICA occlusion due to a fat embolus

2020 ◽  
Vol 2 (1) ◽  
pp. e000017
Author(s):  
Jorn Van Der Veken ◽  
Anna Lo Presti ◽  
Michael J Mulcahy ◽  
Marcus Andrew Stoodley
Keyword(s):  
Mitral Valve ◽  
Carotid Artery ◽  
Internal Carotid Artery ◽  
Internal Carotid ◽  
Fat Embolism ◽  
Artery Occlusion ◽  
Carotid Artery Occlusion ◽  
Rescue Treatment ◽  
The Brain ◽  
Acute Cerebral Ischaemia

BackgroundLarge fat embolus is a rare but potential reversible cause of ischaemic stroke.Methods and resultsWe describe the neurosurgical management of a complete right internal carotid artery occlusion due to a large fat embolus, caused by a mitral valve replacement.ConclusionKnowledge of acute cerebral ischaemia due to large fat embolism and its hallmark ‘hypodense artery’ is mandatory. Extracranial to intracranial bypass is a feasible rescue treatment after failure of endovascular embolectomy.

scholarly journals Successful Bridging Therapy in a 103-Year-Old Woman with Acute Terminal Internal Carotid Artery Occlusion

2020 ◽  
Vol 12 (Suppl. 1) ◽  
pp. 9-14
Author(s):  
Trung Quoc Nguyen ◽  
Hoang Thi Phan ◽  
Tinh Quang Dang ◽  
Vu Thanh Tran ◽  
Thang Huy Nguyen
Keyword(s):  
Carotid Artery ◽  
Internal Carotid Artery ◽  
Internal Carotid ◽  
Intravenous Thrombolysis ◽  
Artery Occlusion ◽  
Carotid Artery Occlusion ◽  
Left Internal Carotid Artery ◽  
Bridging Therapy ◽  
Nihss Score ◽  
Current Guidelines

The efficacy of intravenous thrombolysis and endovascular therapy and their favorable treatment outcomes have been established in clinical trials irrespective of age. Current guidelines do not recommend an age limit in selecting eligible patients for reperfusion treatment as long as other criteria are satisfied. A 103-year-old woman was admitted at our hospital within 1 h of stroke onset secondary to a left internal carotid artery terminus occlusion. On admission, her National Institutes of Health Stroke Scale (NIHSS) score was 30, with a small left thalamic diffusion restriction lesion on MRI. Her medical history included paroxysmal atrial fibrillation, prior myocardial infarction, hypertension, chronic kidney disease, and diabetes mellitus. Her pre-stroke modified Rankin Scale score was 0, and she was fully independent before stroke. Once intravenous thrombolysis was started, the patient successfully underwent mechanical thrombectomy, and thrombolysis in cerebral infarction-3 recanalization was achieved 225 min after symptom onset. She showed dramatic recovery (NIHSS score of 5 after 48 h) and was discharged on day 7 with a modified Rankin Score of 1. To our knowledge, our patient is the second oldest documented patient who successfully underwent bridging therapy for stroke.

scholarly journals Brain Temperature Measured by Magnetic Resonance Spectroscopy to Predict Clinical Outcome in Patients with Infarction

Sensors ◽  
2021 ◽  
Vol 21 (2) ◽  
pp. 490
Author(s):  
Tomohisa Ishida ◽  
Takashi Inoue ◽  
Tomoo Inoue ◽  
Toshiki Endo ◽  
Miki Fujimura ◽  
...  
Keyword(s):  
Magnetic Resonance ◽  
Carotid Artery ◽  
Internal Carotid Artery ◽  
Mr Spectroscopy ◽  
Internal Carotid ◽  
Brain Temperature ◽  
Artery Occlusion ◽  
Carotid Artery Occlusion ◽  
Clinical Settings ◽  
Brain Swelling

Acute ischemic stroke is characterized by dynamic changes in metabolism and hemodynamics, which can affect brain temperature. We used proton magnetic resonance (MR) spectroscopy under everyday clinical settings to measure brain temperature in seven patients with internal carotid artery occlusion to explore the relationship between lesion temperature and clinical course. Regions of interest were selected in the infarct area and the corresponding contralateral region. Single-voxel MR spectroscopy was performed using the following parameters: 2000-ms repetition time, 144-ms echo time, and 128 excitations. Brain temperature was calculated from the chemical shift between water and N-acetyl aspartate, choline-containing compounds, or creatine phosphate. Within 48 h of onset, compared with the contralateral region temperature, brain temperature in the ischemic lesion was lower in five patients and higher in two patients. Severe brain swelling occurred subsequently in three of the five patients with lower lesion temperatures, but in neither of the two patients with higher lesion temperatures. The use of proton MR spectroscopy to measure brain temperature in patients with internal carotid artery occlusion may predict brain swelling and subsequent motor deficits, allowing for more effective early surgical intervention. Moreover, our methodology allows for MR spectroscopy to be used in everyday clinical settings.

Progressive Hydrocephalus as a Complication of Cervical Internal Carotid Artery Occlusion in a 4-Year-Old Child

Neurosurgery ◽  
1981 ◽  
Vol 8 (4) ◽  
pp. 466-468
Author(s):  
Richard J. Lister ◽  
John K. Vries
Keyword(s):  
Carotid Artery ◽  
Internal Carotid Artery ◽  
Internal Carotid ◽  
Artery Occlusion ◽  
Carotid Artery Occlusion ◽  
Internal Carotid Artery Occlusion ◽  
Diagnosis And Management ◽  
Computed Tomographic ◽  
Cervical Internal Carotid Artery

Abstract A case of progressive hydrocephalus as a complication of spontaneous cervical internal carotid artery occlusion in a child is presented. This problem has not been reported previously. The diagnosis and management of this condition are greatly facilitated by computed tomographic scanning.

Contralateral Internal Carotid Artery Occlusion Impairs Early But Not 30-Day Stroke Rate Following Carotid Endarterectomy

Angiology ◽  
2010 ◽  
Vol 61 (7) ◽  
pp. 705-710 ◽  
Author(s):  
Erik Bagaev ◽  
A. Maximilian Pichlmaier ◽  
Theodosios Bisdas ◽  
Mathias H. Wilhelmi ◽  
Axel Haverich ◽  
...  
Keyword(s):  
Carotid Artery ◽  
Internal Carotid Artery ◽  
Carotid Endarterectomy ◽  
Internal Carotid ◽  
Artery Occlusion ◽  
Carotid Artery Occlusion ◽  
Internal Carotid Artery Occlusion ◽  
Stroke Rate ◽  
Contralateral Internal Carotid Artery
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