It is an increasingly common practice to indicate a carotid endarterectomy procedure based on the information provided by non-invasive tests like Duplex ultrasound, MR angiography or CT angiography, thereby obviating the performance of a conventional cerebral angiography. We present a case of symptomatic left carotid artery 80% stenosis in which cerebral angiography showed absence of the right A1 segment and bilateral anterior cerebral artery territories that filled only from a left injection. Just 90seconds after carotid artery clamping at the neck, brain oximetry and somatosensory evoked potentials significantly dropped, that recovered after immediate clamp removal. Endarterectomy was dismissed and a carotid stent was successfully placed. This case highlights the importance of knowing the dynamics of cerebral blood circulation distal to the stenosis. If endarterectomy had been attempted, unawareness of the information provided by the cerebral angiography would have likely result in severe bi-hemispheric ischemia.
Download full-text PDF |
Source |
|---|---|
| http://dx.doi.org/10.1016/j.neucir.2020.03.003 | DOI Listing |
Publication Analysis
Top Keywords
Similar Publications
Incidental Findings on Whole-Body Computed Tomography Angiography in Patients With Suspected Acute Stroke.
Cureus
December 2024
Neurology, Seirei Hamamatsu General Hospital, Hamamatsu, JPN.
Introduction Whole-body computed tomography angiography (CTA) may be useful during cerebral angiography and endovascular treatment (EVT), and identification of thrombi and malignant trunk tumors may be helpful in stroke typing and acute stroke care. Therefore, we aimed to assess the types and prevalence of incidental findings on whole-body CTA in this patient population. Methods This single-center, retrospective, observational study included consecutive patients with suspected acute stroke who underwent whole-body CTA in addition to brain CTA between April 2020 and August 2023.
View Article and Find Full Text PDFBackground: Current guidelines recommend transcatheter aortic valve implantation (TAVI) for patients with aortic stenosis and porcelain aorta (PA). Neurological outcomes of patients with PA undergoing TAVI with modern valves require clarification as most trials examined balloon-expandable valves (BEV) and self-expandable valves in intermediate or high-risk patients, but not specifically in patients with PA. Our aim was to compare outcomes, including stroke and mortality, in well-matched patients with and without PA who received BEV during transfemoral TAVI procedures.
View Article and Find Full Text PDFManagement of Unruptured Infectious Intracranial Aneurysms in Infective Endocarditis: A Case Report and Literature Review.
Cureus
December 2024
Department of Neurosurgery, International University of Health and Welfare Narita Hospital, Narita, JPN.
Infectious intracranial aneurysms (IIAs) are rare lesions with fragile arterial walls located within the aneurysms, carrying a high risk of rupture. Standard management often involves antibiotic therapy and parent artery occlusion; however, the latter carries a significant risk of cerebral infarction. This report presents a case of an unruptured IIA following cerebral infarction, successfully treated with coil embolization while preserving the parent artery.
View Article and Find Full Text PDFPhoton-counting detector CTA to assess intracranial stents and flow diverters: an in vivo study with ultrahigh-resolution spectral reconstructions.
Eur Radiol Exp
January 2025
Department of Neuroradiology, University hospital RWTH Aachen, Aachen, Germany.
Background: To define optimal parameters for the evaluation of vessel visibility in intracranial stents (ICS) and flow diverters (FD) using photon-counting detector computed tomography angiography (PCD-CTA) with spectral reconstructions.
Methods: We retrospectively analyzed consecutive patients with implanted ICS or FD, who received a PCD-CTA between April 2023 and March 2024. Polyenergetic, virtual monoenergetic, pure lumen, and iodine reconstructions with different keV levels (40, 60, and 80) and reconstruction kernels (body vascular [Bv]48, Bv56, Bv64, Bv72, and Bv76) were evaluated by two radiologists with regions of interests and Likert scales.
Behçet's disease: recurrent ischemic stroke as an initial presentation - a case based review.
J Int Med Res
January 2025
Rheumatology Department, Faculty of Medicine, Cairo University, Cairo, Egypt.
Behçet's disease (BD) is a rare systemic vasculitis that is characterized by recurrent oral and genital ulcers, uveitis, and skin lesions. Although neurological involvement is a known complication, ischemic stroke remains uncommon. Herein, we report a 37-year-old Kuwaiti woman who experienced recurrent ischemic stroke with no traditional risk factors.
View Article and Find Full Text PDFWant AI Summaries of new PubMed Abstracts delivered to your In-box?
Enter search terms and have AI summaries delivered each week - change queries or unsubscribe any time!