Cerebral infarction due to carotid occlusion caused by cervical vagal neurilemmoma: report of a case.
BACKGROUND
We report a case of a 71-year-old woman with cerebral infarction due to occlusion of the internal carotid artery (ICA) caused by a neck tumor.


METHODS
In 1998, the patient complained of mild hoarseness, and a diagnostic workup showed a cervical mass that was considered a benign neck tumor. In September 2000, she developed right-sided weakness. Diffusion-weighted MRI showed a high-intensity area in the territory of the left middle cerebral artery. Carotid angiography and ultrasonography revealed occlusion of the left ICA, which was due to compression by the neck tumor. Superficial temporal artery-middle cerebral artery anastomosis was performed to prevent critical reduction of cerebral blood flow in the left ICA territory; this was followed by tumor resection. The occluded ICA recanalized after tumor resection. Microscopic examination showed that the tumor was a vagal neurilemmoma.


CONCLUSIONS
This is the first case of cerebral infarction due to left ICA occlusion by a cervical neurilemmoma. Even when the neck tumor is benign, it may occlude the ICA and thereby cause cerebral infarction.
Matsuo
Ryu
R
Department of Cerebrovascular Disease, National Kyushu Medical Center, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan. rymatsuo@df6.so-net.ne.jp
Kamouchi
Masahiro
M
Inoue
Tooru
T
Okada
Yasushi
Y
Ibayashi
Setsuro
S
D000368:Aged; D000792:Angiography; D002339:Carotid Arteries / Q000000981:diagnostic imaging; D002340:Carotid Artery Diseases / Q000175:diagnosis / Q000209:etiology* / Q000601:surgery; D002544:Cerebral Infarction / Q000175:diagnosis / Q000209:etiology*; D005260:Female; D006258:Head and Neck Neoplasms / Q000150:complications* / Q000175:diagnosis* / Q000473:pathology / Q000601:surgery; D006801:Humans; D008279:Magnetic Resonance Imaging; D009442:Neurilemmoma / Q000150:complications* / Q000175:diagnosis* / Q000473:pathology / Q000601:surgery; D014463:Ultrasonography; D014630:Vagus Nerve / Q000473:pathology