Document Detail

Small Carotid Thrombus and Minimal Stenosis Causing Repeated Embolic Strokes.
MedLine Citation:
PMID:  21332872     Owner:  NLM     Status:  Publisher    
Despite current developments in neuroradiology, the sources of infarctions go undiagnosed in 28% of cases. An embolic source in the setting of minimal stenosis at the carotid bifurcation has rarely been reported. The authors report a previously healthy 48-year-old woman, without any risk factors for cerebrovascular events, sustained multiple cerebral infarctions in the right anterior and middle cerebral artery territory. Repeated imaging of the heart and cerebral vessels missed a very small abnormality arising from the posterior wall of the internal carotid artery, until it was diagnosed by computed tomographic angiography. This is problematic because by North American Symptomatic Carotid Endarterectomy Trial (NASCET) criteria, minimal stenosis essentially excludes the carotid artery as an embolic source. Despite maximum antiplatelet and anticoagulation therapy, she continued to have neurological deteriortation by progression of her strokes. She underwent standard carotid endarterectomy and sustained no new embolic phenomena. Histopathological examination showed an endothelial hyperplasia with organizing thrombus, which on the posterior wall of the internal carotid artery, is likely a hemodynamically induced on top of preexisting atherosclerotic plaque. J Neuroimaging 2011;XX:1-3.
Hoan Tran; Howard Yonas
Publication Detail:
Type:  JOURNAL ARTICLE     Date:  2011-2-18
Journal Detail:
Title:  Journal of neuroimaging : official journal of the American Society of Neuroimaging     Volume:  -     ISSN:  1552-6569     ISO Abbreviation:  -     Publication Date:  2011 Feb 
Date Detail:
Created Date:  2011-2-21     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  9102705     Medline TA:  J Neuroimaging     Country:  -    
Other Details:
Languages:  ENG     Pagination:  -     Citation Subset:  -    
Copyright Information:
Copyright © 2011 by the American Society of Neuroimaging.
From the Department of Neurosurgery, University of New Mexico, Albuquerque, NM.
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