scholarly journals Ischemic Stroke Caused by Carotid Stump at the Common Carotid Artery

2020 ◽  
Vol 59 (23) ◽  
pp. 3071-3074
Author(s):  
Go Hashimoto ◽  
Shinichi Wada ◽  
Takao Morita ◽  
Saori Tomohara ◽  
Kenta Hara ◽  
...  
2018 ◽  
Vol 31 (06) ◽  
Author(s):  
Monika Chorazy ◽  
Dominika Jakubowicz-Lachowska ◽  
Michal Szczepanski ◽  
Katarzyna Krystyna Snarska ◽  
Agata Krajewska ◽  
...  

2020 ◽  

Background: There are no guidelines for the optimal timing of surgery (emergency vs. delayed) for ascending aortic dissection with acute ischemic stroke. We retrospectively compared the prognoses and radiological and clinical findings for concomitant aortic dissection and ischemic stroke in a series of case reports. Case presentation: Three patients presented with left hemiparesis. Patient 1 underwent surgery for acute aortic dissection without treatment for acute ischemic stroke. In Patient 2, emergency stenting could not be performed due to cardiac tamponade and hypotension. Therefore, emergency acute aortic dissection surgery was performed. Patient 3 underwent emergency right common carotid artery stenting followed by surgery for acute aortic dissection. Brain perfusion computed tomography angiography (CTA) was performed to diagnose severe stenosis of the right common carotid artery or occlusion concomitant with acute aortic dissection involving the aortic arch with a cerebral perfusion mismatch in all the patients. Patient 3 had postoperative local cerebral infarction, whereas patients 1 and 2 (without stent insertion) had extensive postoperative cerebral infarction. Conclusion: Patient 3 showed a better prognosis than patients without stent treatment. We suggest that perfusion CTA of the aortic arch in suspected acute ischemic stroke can facilitate early diagnosis and prompt treatment in similar patients.


Author(s):  
Brian Silver ◽  
Irene Gulka ◽  
Michael Nicolle ◽  
Ramesh Sahjpaul ◽  
Vladimir Hachinski

Background:The observation of an intraluminal common carotid artery thrombus overlying a wall defect at ultrasonography or angiography is unusual. To our knowledge, there are no previous reports of a free-floating thrombus in the common carotid artery.Case Report:A 45-year-old woman who was previously healthy and on no medications presented with acute hemiparesis and aphasia. Following testing that included carotid duplex and trancranial Doppler ultrasonography, diffusion-weighted magnetic resonance imaging, and digital subtraction angiography, the patient underwent emergency open embolectomy. No underlying wall defect was seen at the time of imaging or surgery. No obvious hypercoagulable state could be identified. Her NIH Stroke Scale score improved from 26 at admission to 2 at three months and 1 at one year.Conclusions:Multimodal imaging may have improved diagnosis and management in this patient with a unique finding. The source of the thrombus remains obscure.


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