Acute Bilateral Internal Carotid Artery Occlusion Presenting with Symmetric Cortical Infarctions Exhibits Dramatic Improvement After Mechanical Thrombectomy.

Abstract:

BACKGROUND:Acute bilateral internal carotid artery (ICA) occlusion has rarely been reported to exhibit an improvement in prognosis. Herein, we report a case of acute bilateral ICA occlusion presenting with bilateral symmetric cortical and basal-ganglia infarctions that exhibited dramatic improvement after a mechanical thrombectomy. CASE DESCRIPTION:The patient was a 72-year-old man with a history of hypertension who presented with a coma and quadriplegia during sleep and experienced moderate vomiting and diarrhea the day before admission to our hospital. Neurologic examination revealed that the patient was in a coma (National Institutes of Health Stroke Scale 35). A brain computed tomography (CT) scan showed a hypodense lesion in the bilateral frontal cortex. An emergency cerebral angiography demonstrated complete occlusion of the bilateral ICA. Subsequently, a mechanical thrombectomy of the bilateral ICA was successfully performed. At a 3-month follow-up, the patient had residual slight aphasia and quadriparesis (National Institutes of Health Stroke Scale 16). CONCLUSIONS:Bilateral ICA occlusion should be considered if a patient presents with a coma, quadriplegia, and symmetric cortical infarctions. In such a case, a bilateral mechanical thrombectomy may represent a potential treatment for improving the prognosis of the affected patient.

journal_name

World Neurosurg

journal_title

World neurosurgery

authors

Huang J,Liu H,Chen H,Yuan L,Fang L,Yang Z

doi

10.1016/j.wneu.2020.06.041

subject

Has Abstract

pub_date

2020-09-01 00:00:00

pages

149-152

eissn

1878-8750

issn

1878-8769

pii

S1878-8750(20)31299-7

journal_volume

141

pub_type

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