This report presents a unique finding of an incidental right internal carotid artery dissection in an asymptomatic 69-year-old man. The report highlights the possible trigger and long-term outcomes of this condition. The patient had participated in Japanese archery competitions for many years. His medical history included hypertension and a prior ischemic stroke in the left lateral medulla, resulting in Wallenberg syndrome. During a routine visit, head magnetic resonance angiography revealed right internal carotid artery dissection. He was managed conservatively with antiplatelet therapy and close monitoring. Follow-up imaging after 10 years showed no changes, and the patient remained asymptomatic. Therefore, routine screening for incidental findings is important even in asymptomatic patients. Archery competitions may be a possible trigger for internal carotid artery dissection. The presence of re-entry in the lesion at the time of onset can be a predictor of a good long-term prognosis.
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http://dx.doi.org/10.1177/00368504231214119 | DOI Listing |
Neurology
February 2025
Department of Neurology, Department of Stroke, University Hospital Cleveland Medical Center, Case Western Reserve University, Cleveland, OH.
Background And Objectives: Although previous trials have established the efficacy and safety of endovascular thrombectomy (EVT) in large ischemic core strokes, most of them excluded patients with extracranial internal carotid artery (e-ICA) occlusion. We aimed to compare outcomes in patients with e-ICA occlusion and large ischemic core infarcts treated with EVT vs medical management (MM).
Methods: This was a secondary analysis of the SELECT2 trial, a randomized controlled trial conducted at 31 international sites.
J Am Heart Assoc
January 2025
Research Institute of Internal Medicine, Oslo University Hospital Oslo Norway.
Background: Complement activation may promote atherosclerosis. Yet, data on the to which extent complement, and more specifically the alternative complement pathway, is activated in patients with carotid atherosclerosis and related to adverse outcome in these patients, are scarce.
Methods And Results: We measured, by ELISA, plasma levels of factor D, properdin, C3bBbP (C3 convertase), and factor H in patients with advanced carotid atherosclerosis in a (n=324) and in a (n=206) cohort in relation to adverse outcome (mean follow-up 7.
Clin Transl Radiat Oncol
March 2025
Department of Radiation Oncology, The University of Texas MD Anderson Cancer Center, 1515 Holcombe Blvd, Houston, TX 77030, USA.
Aim: This study leveraged standard-of-care CT scans of patients receiving unilateral radiotherapy (RT) for early tonsillar cancer to detect volumetric changes in the carotid arteries, and determine whether there is a dose-response relationship.
Methods: Disease-free cancer survivors (>3 months since therapy and age > 18 years) treated with intensity modulated RT for early (T1-2, N0-2b) tonsillar cancer with pre- and post-therapy contrast-enhanced CT scans available were included. Patients treated with definitive surgery, bilateral RT, or additional RT before the post-RT CT scan were excluded.
Acute Med Surg
January 2025
Department of Emergency and Critical Care Medicine Institute of Medicine, University of Tsukuba Hospital Tsukuba Ibaraki Japan.
Background: Traumatic intracranial aneurysms (TICAs) can be fatal if ruptured. We report a case of a TICA, distant from facial bone fractures, successfully treated with flow diverter (FD) before rupture.
Case Presentation: A 20-year-old woman was admitted following a car accident.
Int Med Case Rep J
January 2025
Department of Cardiology, Rugao Affiliated Hospital of Nantong University, Rugao People's Hospital, Nantong, Jiangsu, People's Republic of China.
Background: Acute ischemic stroke (AIS) is usually caused by acute occlusion of the cerebral artery. Bilateral anterior cerebral arteries (ACAs) originating from the anterior communicating branch of the same internal carotid artery are a rare anatomical variation in clinical practice. Mechanical thrombectomy (MT) of simultaneous acute occlusion of the bilateral ACAs with this variation has rarely been reported.
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