title: Recurrent embolic stroke originating from an internal carotid aneurysm in a young adult.
abstract: An unruptured intracranial aneurysm is an uncommon but possible embolic source to the brain. We report a young patient who developed recurrent ischemic strokes occurring mainly in the left internal carotid arterial territory within a short interval; the first stroke occurred midway through a long-distance race, and the second stroke occurred immediately following a bowel movement. The angiographical contrast deficit indicated a thrombus in the left anterior cerebral artery as a result of the embolism. A saccular aneurysm of the left distal internal carotid artery was the only detectable potential embolic source. Initially anticoagulant therapy was given, and then surgical clipping of the aneurysm was performed. The patient has been free from stroke recurrence. As a cause of ischemic stroke in young adults, a carotid saccular aneurysm should be considered. Hard exercise and a Valsalva maneuver may be important triggers of thrombus detachment from the aneurysm.
authors.affiliation: Department of Cerebrovascular Disease, Cerebrovascular Center and Clinical Research Institute, National Kyushu Medical Center, 1-8-1 Jigyohama, Fukuoka 810-8563, Japan.
authors.forename: Toshifumi
authors.initials: T
authors.lastname: Shimada
authors.forename: Kazunori
authors.initials: K
authors.lastname: Toyoda
authors.forename: Noriko
authors.initials: N
authors.lastname: Hagiwara
authors.forename: Tetsuro
authors.initials: T
authors.lastname: Sayama
authors.forename: Tooru
authors.initials: T
authors.lastname: Inoue
authors.forename: Kotaro
authors.initials: K
authors.lastname: Yasumori
authors.forename: Yasushi
authors.initials: Y
authors.lastname: Okada
mesh_terms: D002340:Carotid Artery Diseases / Q000150:complications* / Q000188:drug therapy / Q000601:surgery; D002342:Carotid Artery, External / Q000473:pathology; D002533:Cerebral Angiography; D005343:Fibrinolytic Agents / Q000627:therapeutic use; D006801:Humans; D020243:Infarction, Anterior Cerebral Artery / Q000473:pathology; D002532:Intracranial Aneurysm / Q000150:complications* / Q000188:drug therapy / Q000601:surgery; D020766:Intracranial Embolism / Q000209:etiology*; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D019635:Neurosurgical Procedures; D012008:Recurrence; D020521:Stroke / Q000209:etiology*; D013788:Thalamus / Q000473:pathology; D014656:Vascular Surgical Procedures
chemical_list: D005343:Fibrinolytic Agents