Presentation
We present a case of bilateral carotid artery occlusion presented with intraventricular hemorrhage. [ncbi.nlm.nih.gov]
Entire Body System
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Coronary Atherosclerosis
The major treatable risk factors for carotid artery atherosclerosis are similar to those for coronary atherosclerosis. Therefore patients with carotid stenosis should be screened for diabetes mellitus, dyslipidemia and hypertension. 2. [clinicaladvisor.com]
Relation of extent of extracranial carotid artery atherosclerosis as measured by B-mode ultrasound to the extent of coronary atherosclerosis. Arterioscler Thromb. 1991;11:1786-94 [ Links ] 26. Kotsis VT, Stabouli SV, Papamichael CM, Zakopoulos NA. [scielo.br]
Obesity, hyperlipidemia, sedentary lifestyle, and cigarette smoking, are major factors (they are also implicated as causes of coronary atherosclerosis and insufficiency). [dartmouth.edu]
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Coarctation of the Aorta
Abstract An 11-year-old boy developed occlusion of the left internal carotid artery (ICA) following surgical correction of atypical coarctation of the aorta. [ncbi.nlm.nih.gov]
Respiratoric
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Pharyngitis
The inferior pharyngeal constrictor (IPC) mean dose was 5,341, 6,456, and 6,451 cGy for IMRT, 3D RT, and 2D RT, respectively. IMRT provided the best homogeneity but at a higher cost and with prolonged treatment time. [ncbi.nlm.nih.gov]
Cardiovascular
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Carotid Bruit
Carotid bruits are not sensitive or specific enough to confirm or exclude significant carotid stenoses. [ 3 ] Absence of carotid bruit in patients with cardiovascular disease does not exclude a carotid stenosis. [patient.info]
Carotid Bruit A carotid bruit is auscultated with diaphragm of stethoscope at the level of thyroid cartilage. A high-pitched prolonged carotid bruit fading into diastole is often associated with tightly stenotic lesions. [slideshare.net]
Prospective comparison of a cohort with asymptomatic carotid bruit and a population-based cohort without carotid bruit. Stroke. 1990;21:984–8. 27. Norris JW, Zhu CA, Bornstein NM, Chambers BR. Vascular risks of asymptomatic carotid stenosis. [aafp.org]
Eyes
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Diplopia
Another symptom that might raise a red flag would be when a patient reports ischemic diplopia, PCON Editorial Board member John A. McCall Jr., OD, said in an interview. “Anytime a patient has double vision, it’s due to a microclot,” he said. [healio.com]
The two commonest ocular lesions are homonymous hemianopia and uniocular blindness or optic atrophy, although diplopia, ptosis, papilloedema, and pupillary changes may occur. Uniocular blindness may be transient (amaurosis fugax) or permanent. [ijo.in]
Luo et al. found that among 42 patients with OIS, 35 presented with more than two ocular symptoms, including visual loss, ocular/periorbital pain, amaurosis fugax, photophobia, floaters, metamorphopsia, phosphenes, and diplopia. [27] Visual Loss Decrease [eyewiki.aao.org]
Alone or in various combinations, vertigo, bilateral blurring or loss of vision, ataxia, diplopia, bilateral or unilateral (occasionally alternating) sensory and motor deficits, and syncope are common manifestations of vertebrobasilar insufficiency. [dartmouth.edu]
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Transient Blindness
Symptoms of carotid artery stenosis include transient blindness in one eye, weakness or numbness of an arm, leg or the face, or the temporary inability to speak or to understand conversation. [newsnetwork.mayoclinic.org]
Transient blindness, amaurosis fugax, has previously been reported in patients with a fully occluded ipsilateral internal carotid, unequivocally indicating the collateral pathway to be a mechanism for retinal embolization (2). [spandidos-publications.com]
blindness after coronary artery bypass surgery 116 Medikal pulmoner arter kateter komplikasyonu pulmonary artery catheter complication 117 Medikal sağ atriuma dikilen pulmoner arter kateteri pulmonary artery catheter suturing to the right atrium wall [tureng.com]
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Foreign Body Sensation
The sole perioperative complication was a complaint of foreign body sensation on swallowing in 1 patient. [ncbi.nlm.nih.gov]
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Dry Eyes
A case of unilateral dry eye associated with ipsilateral carotid artery occlusion. [ncbi.nlm.nih.gov]
Neurologic
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Stroke
CONCLUSIONS: The rate of ischemic stroke following carotid sacrifice remains high and most strokes are thromboembolic in nature. Our testing protocol did not eliminate the risk of hypoperfusion-related stroke. [ncbi.nlm.nih.gov]
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Dizziness
Clinical symptoms included dizziness, amaurosis fugax, persistent limb numbness, and transient ischemic attack. [ncbi.nlm.nih.gov]
An 86-year-old male patient in our study with bilateral occlusion and widespread atherosclerosis without focal neurological signs was examined by ultrasound for nonspecific dizziness. [hindawi.com]
Predominant symptoms and signs included visual-ipsilateral monocular or retrochiasmal symptoms (88%), motor weakness (88%), sensory disturbance (59%), dizziness/lightheadedness (53%), and syncope (24%). [n.neurology.org]
[…] identified, as well as hypoplastic left vertebral artery.( Figure 1 ) One week after arteriography was performed, the patient presented a picture of transitory ischemic stroke again with motor deficit in upper right limb, accompanied by episodes of dizziness [scielo.br]
Case report A 70 year old male presented to the Department of Neurosurgery at Xuanwu Hospital of Capital Medical University (Beijing, China) in April 2014 after having suffered from intermittent dizziness for 6 months. [spandidos-publications.com]
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Hemianesthesia
On the following day, the patient presented with left hemiplegia with hemianesthesia (National Institutes of Health Stroke Scale score 14). [ncbi.nlm.nih.gov]
When the origins of both the ACA and MCA are occluded at the top of the carotid artery, abulia or stupor occurs with hemiplegia, hemianesthesia, and aphasia or anosognosia. [slideshare.net]
Findings related to the ACA territory are as follows: Crural paresis arm paresis Frontal signs (eg, abulia) Findings related to the anterior choroidal artery territory are as follows: Hemiparesis Hemianesthesia Homonymous hemianopia Lacunar syndromes [emedicine.medscape.com]
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Frontal Headache
A 50-year-old man who presented with a history of sudden onset of frontal headache and visual impairment was admitted to another medical centre and MRI revealed a non-enhancing sellar lesion with suprasellar and infrasellar extension. [ncbi.nlm.nih.gov]
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Learning Difficulties
There was normal neuropsychomotor development until 5 years of age, when marked learning difficulties were observed at school. [surgicalneurologyint.com]
Workup
Our case highlights the utility of urgent cardiovascular workup and referral to a subspecialist pending further workup. [hindawi.com]
However, in the setting of symptoms suggestive of stroke or TIA, workup for this condition may be indicated. [unboundmedicine.com]
Nondiabetic patients younger than 70 years with no cardiac symptoms and normal findings on electrocardiography (ECG) may undergo CEA without further cardiac workup. [emedicine.medscape.com]
Asymptomatic carotid artery occlusion (ACAO) is most frequently discovered as an incidental finding during radiological workup for cerebrovascular disease or after auscultation of a neck bruit. 3 Improvements in ultrasound technology and wide-scale diffusion [ahajournals.org]
A basic workup should therefore include a complete blood cell count with differential, serum protein electrophoresis, and immunoelectrophoresis. Table 2. [eyewiki.aao.org]
Angiography
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Mural Thrombus
The supraclinoid internal carotid artery also revealed endothelial denudation and mural thrombus. We provide a histopathologic report of vessel wall injury after SRT that caused failed recanalization. [ncbi.nlm.nih.gov]
Hypertrophy
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Ventricular Hypertrophy
All seven patients showed severe left ventricular hypertrophy (LVH) according to an increased cardiothoracic ratio (CTR) 50 %. [ncbi.nlm.nih.gov]
Treatment
Treatment consisted of surgery for eight aneurysms and endovascular embolization for 13 aneurysms. No invasive treatment was recommended for 14 aneurysms (eight patients with single aneurysm). [ncbi.nlm.nih.gov]
Prognosis
Patients were evaluated by modified Rankin Scale in terms of prognosis at discharge and after 3 months. [ncbi.nlm.nih.gov]
The nature and severity of the presenting ischaemic symptoms did not appear to have a significant impact on prognosis. [karger.com]
Etiology
Progressive occlusion of a major intracranial artery, independently from the etiology, can lead to the development of collateral arterial networks that supply blood flow to distal territories beyond the occlusion. [ncbi.nlm.nih.gov]
Stroke etiology was 2 cardioembolic, 11 atherothrombotic, and a single unspecified case. [ajnr.org]
Epidemiology
Further studies on the epidemiology of de novo aneurysms after carotid artery occlusion are warranted. [ncbi.nlm.nih.gov]
[…] artery occlusion, vertebrobasilar occlusion, dissections, cerebral venous and sinus thrombosis, thrombolysis, mechanical recanalization materials, and treatment concepts and results, with information on anatomy, imaging studies, etiology, symptoms, epidemiology [medical-dictionary.thefreedictionary.com]
Epidemiology [ 1 ] Moderate-to-severe asymptomatic carotid atherosclerotic stenosis occurs in 2-5% of European women and 2-8% of European men aged over 60 years. The prevalence is much higher in high-risk groups. Risk factors Increasing age. [patient.info]
Cervical Artery Dissection: A Review of the Epidemiology, Pathophysiology, Treatment, and Outcome. Arch Neurosci. 2015. 2: e26670- 6. Bögershausen N, Altunoglu U, Beleggia F, Yigit G, Kayserili H, Nürnberg P. [surgicalneurologyint.com]
Pathophysiology
We hypothesize that most of these cases share similar pathophysiology with the more common perinatal arterial ischemic stroke but differ by a persistent identified thrombus in the carotid artery at the time of first imaging, leading to a more severe and [ncbi.nlm.nih.gov]
Complete occlusion of extracranial internal carotid artery: clinical features, pathophysiology, diagnosis and management Bhomraj Thanvi 1, Tom Robinson 2 1 Department of Integrated Medicine, Glenfield General Hospital, University Hospitals of Leicester [pmj.bmj.com]
The cerebral hemodynamic insufficiency has been considered as the primary pathophysiological factor for patients with ICA or MCA occlusion. [clinicaltrials.gov]
Prevention
Abstract Inadvertent occlusion of an internal carotid artery (ICA) during stenting may be a catastrophic situation requiring a bailout operation to prevent permanent neurologic sequelae. [ncbi.nlm.nih.gov]