scholarly journals Left internal carotid artery agenesis in a patient with headache

2014 ◽  
pp. 25-27
Author(s):  
Inês Alice Teixeira Leão ◽  
C. H. Rezende ◽  
J. B. L. Gomes ◽  
R. F. Almeida
Keyword(s):  
Computed Tomography ◽  
Carotid Artery ◽  
Internal Carotid Artery ◽  
Rare Case ◽  
Internal Carotid ◽  
Left Internal Carotid Artery ◽  
Left Middle Cerebral Artery ◽  
Clinical Neurology ◽  
Structural Lesion ◽  
Left Middle

Sometimes in clinical neurology, we diagnose a very rare case. We report on a patient who presented with crisis of headache and vomiting (clinically diagnose as migraine). Computed tomography (CT) scan of the head did not reveal any structural lesion. Magnetic resonance angiography showed absence of left internal carotid artery associated with absence of the left middle cerebral artery (MCA).

Management of Mobile Thrombus With Distal Protection Devices During Carotid Artery Angioplasty: 2-Dimensional Operative Video

2021 ◽  
Author(s):  
Salomon Cohen-Cohen ◽  
Giuseppe Lanzino ◽  
Waleed Brinjikji ◽  
Adam Arthur ◽  
Mark Bain ◽  
...  
Keyword(s):  
Carotid Artery ◽  
Internal Carotid Artery ◽  
Internal Carotid ◽  
Mechanical Thrombectomy ◽  
Standard Of Care ◽  
Video Production ◽  
Left Internal Carotid Artery ◽  
Left Middle Cerebral Artery ◽  
Cerebral Angiogram ◽  
Protection Devices

Abstract Embolic protection devices (EPDs) have become a standard of care during internal carotid artery revascularization.1,2 This video is about a 57-yr-old-male who presented with a wake-up stroke with a left hemispheric syndrome. Head computed tomography angiography (CTA) revealed tandem occlusions of the proximal left internal carotid artery (ICA) and of the distal left middle cerebral artery (MCA) with an ASPECT (Alberta Stroke Program Early CT Score) score of 6. The patient underwent a cerebral angiogram and was treated with balloon angioplasty with a distal EPD and mechanical thrombectomy. The EPD became occluded with thrombus from the ICA and was retrieved through a 6-Fr Sofia (MicroVention) under continuous aspiration. Successful revascularization of the proximal ICA and distal MCA was achieved. No procedure-related complications occurred, and the patient's neurological exam improved. Tandem occlusions can occur in up to 15% of strokes. The optimal treatment can be controversial, but mechanical thrombectomy and ICA revascularization with a distal EPD appear to be safe and effective in selected patients.3 Consent was obtained for the procedure and for the video production.

scholarly journals Mechanical thrombectomy utilising a collateral pathway in a patient with dysgenesis of the internal carotid artery

2018 ◽  
Vol 25 (1) ◽  
pp. 54-57
Author(s):  
Jun Tsukano ◽  
Satoshi Kurabe ◽  
Tsutomu Sugai ◽  
Manabu Wada ◽  
Takashi Kumagai
Keyword(s):  
Carotid Artery ◽  
Internal Carotid Artery ◽  
Middle Cerebral Artery ◽  
Cerebral Artery ◽  
Internal Carotid ◽  
Mechanical Thrombectomy ◽  
Left Middle Cerebral Artery ◽  
Collateral Pathway ◽  
Guiding Catheter ◽  
Left Middle

We describe a case of acute middle cerebral artery occlusion in a patient with ipsilateral internal carotid artery dysgenesis successfully treated with mechanical thrombectomy utilising a collateral pathway. During the procedure, a triaxial system using a balloon guiding catheter, flexible large lumen aspiration catheter and stent retriever was advanced from the left vertebral artery to the occluded left middle cerebral artery through the left posterior communicating artery. Because proximal aspiration from the balloon guiding catheter alone might have insufficient suction force due to the retrograde blood flow from large vascular communications (e.g. vertebral artery union), the tip of the flexible large lumen aspiration catheter was set at the proximal left middle cerebral artery, and distal aspiration was added during stent retrieval. A thrombolysis in cerebral infarction 2b result was achieved after the first pass. In this case, identification of carotid canal hypoplasia on computed tomography allowed for an immediate attempt of this alternative approach, avoiding a delay in the time to reperfusion.

scholarly journals A Case of Occlusive Radiation Vasculopathy Presenting as Bilateral Internal Carotid Artery, Left Middle Cerebral Artery Occlusion and Literature Review

2020 ◽  
Vol 12 (Suppl. 1) ◽  
pp. 91-96
Author(s):  
Yung-Chuan Huang ◽  
Shin-Leh Huang ◽  
Hon-Man Liu ◽  
Hou-Chang Chiu
Keyword(s):  
Carotid Artery ◽  
Literature Review ◽  
Internal Carotid Artery ◽  
Middle Cerebral Artery ◽  
Cerebral Artery ◽  
Internal Carotid ◽  
Tongue Cancer ◽  
Artery Occlusion ◽  
Left Middle Cerebral Artery ◽  
Left Middle

Radiation vasculopathy is one of the rare causes of ischemic stroke. Carotid stenosis with large volume infarction may occur years after radiation therapy for head or neck cancer. We report a case of a patient with bilateral internal carotid artery occlusion presenting with left middle cerebral artery infarct 10 years after receiving treatment for tongue cancer. A literature review and discussion of treatment for such patients are presented.

scholarly journals Luxury Perfusion Producing Sensory Aphasia

2021 ◽  
pp. 46-49
Author(s):  
Daiki Sakai ◽  
Ryuji Sakakibara ◽  
Fuyuki Tateno ◽  
Yosuke Aiba
Keyword(s):  
Brain Injury ◽  
Carotid Artery ◽  
Internal Carotid Artery ◽  
Middle Cerebral Artery ◽  
Internal Carotid ◽  
Left Middle Cerebral Artery ◽  
Sensory Aphasia ◽  
Luxury Perfusion ◽  
Old Japanese ◽  
Left Middle

We describe the case of an 86-year-old Japanese man who, by luxury perfusion after spontaneous recanalization of the left middle cerebral artery/internal carotid artery, produced acute transient sensory aphasia. This rare phenomenon is thought to be caused by reperfusion brain injury.

Retained Transcranial Knife Blade With Transection of the Internal Carotid Artery Treated by Staged Endovascular and Surgical Therapy: Technical Case Report

2015 ◽  
Vol 11 (2) ◽  
pp. 372-375 ◽  
Author(s):  
Lisa M Kodadek ◽  
W Robert Leeper ◽  
Justin M Caplan ◽  
Camilo Molina ◽  
Kent A Stevens ◽  
...  
Keyword(s):  
Computed Tomography ◽  
Carotid Artery ◽  
Internal Carotid Artery ◽  
Surgical Therapy ◽  
Coil Embolization ◽  
Foreign Bodies ◽  
Internal Carotid ◽  
Left Internal Carotid Artery ◽  
Knife Blade ◽  
Neurologically Intact

Abstract BACKGROUND AND IMPORTANCE We describe the use of proximal and distal endovascular coil embolization of the internal carotid artery followed by operative removal of a retained foreign object transecting the petrocavernous portion of the internal carotid artery. CLINICAL PRESENTATION A 20-year-old man sustained a stab wound to the left temporal skull and presented with a retained knife blade. He reported a headache at presentation, but remained neurologically intact with a Glasgow Coma Scale of 15. Computed tomography imaging and subsequent angiography confirmed complete transection of the petrocavernous segment of the left internal carotid artery with effective tamponade by the knife blade in situ and satisfactory collateral flow across the Circle of Willis. Coil embolization of the left internal carotid artery was performed. Retrograde embolization of the petrocavernous internal carotid segment distal to the injury was performed via vertebral and posterior communicating artery access. Antegrade embolization of the internal carotid artery proximal to the injury was completed and the patient was transferred to the operating room for craniectomy and foreign body extraction. Postoperative computed tomography angiography revealed no parenchymal hemorrhage, mass effect, or midline shift, and successful embolization of the internal carotid artery. At 6-week follow-up, the patient remained neurologically intact with no infectious or vascular complications. CONCLUSION Staged endovascular and surgical therapy provides complete assessment and effective control of damaged vessels when retained intracranial foreign bodies are present. Given the high risk of vascular injury with retained transcranial foreign bodies, this strategy should be considered a safe approach for these challenging cases.

scholarly journals Hybrid approach in tandem high-grade carotid stenoses: A case report

2020 ◽  
Vol 28 (3) ◽  
pp. 539-542
Author(s):  
Valentin Govedarski
Keyword(s):  
Carotid Artery ◽  
Internal Carotid Artery ◽  
Common Carotid Artery ◽  
Internal Carotid ◽  
Left Common Carotid Artery ◽  
Coronary Artery Bypass Grafts ◽  
Left Internal Carotid Artery ◽  
Left Middle Cerebral Artery ◽  
High Grade ◽  
History Of

A 79-year-old male patient who presented with dizziness and several syncopal episodes was admitted to our clinic. Medical history of the patient revealed arterial hypertension and multifocal atherosclerosis with a history of two ischemic left middle cerebral artery strokes within the last year, without residual deficits, two coronary artery bypass grafts 22 years ago, and Stage IIB peripheral artery disease. The imaging studies revealed severe stenosis of the left internal carotid artery and high-grade ostial stenosis of the left common carotid artery. After clamping of the internal carotid artery and endarterectomy with patch angioplasty, before the patch was completely sutured, a sheath was placed through it and dilation and retrograde stenting of the proximal segment of the left common carotid artery were performed. The neurological symptoms of the patient disappeared and on postoperative computed tomography angiography, there was no residual carotid stenosis.

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