Oscillating thromboemboli within the extracranial internal carotid artery demonstrated by ultrasonography in patients with acute cardioembolic stroke.
We detected oscillating thromboemboli at the extracranial internal carotid artery (ICA) by duplex carotid ultrasonography in patients with acute cardioembolic stroke. Using B-mode ultrasonography, we evaluated the extracranial ICA in 11 patients with acute cardioembolic ICA occlusion. A homogeneous, elastic, oscillating intraluminal mass echo originating in the extracranial ICA extended distally in 5 (46%) of these patients. The echoes moved quickly and distally during the systolic phase of the cardiac cycle and returned slowly to the original position during the diastolic phase. We performed a postmortem study 24 days after stroke onset in 1 patient with an oscillating intraluminal mass echo that had been demonstrated by duplex ultrasonography. The ICA lumen was obstructed with a fresh string-like thrombus. The findings of oscillating intraluminal mass echo may help establish a diagnosis of acute embolic ICA occlusion.
Kimura
K
K
Department of Medicine, National Cardiovascular Center, Suita, Osaka, Japan.
Yasaka
M
M
Minematsu
K
K
Wada
K
K
Uchino
M
M
Yonemura
K
K
Ogata
J
J
Yamaguchi
T
T
D000208:Acute Disease; D000368:Aged; D001783:Blood Flow Velocity; D002341:Carotid Artery Thrombosis / Q000000981:diagnostic imaging* / Q000209:etiology; D002343:Carotid Artery, Internal / Q000000981:diagnostic imaging*; D002533:Cerebral Angiography; D002561:Cerebrovascular Disorders / Q000000981:diagnostic imaging* / Q000209:etiology; D005260:Female; D005500:Follow-Up Studies; D006331:Heart Diseases / Q000150:complications* / Q000503:physiopathology; D006801:Humans; D008297:Male; D009200:Myocardial Contraction; D018616:Ultrasonography, Doppler, Duplex