Cardiogenic embolism producing crescendo transient ischemic attacks.
Lateralizing, repetitive transient ischemic attacks are characteristic of symptomatic carotid bifurcation atherosclerotic plaques. We report a case in which a cardiogenic embolus, after lodging at the left carotid bifurcation, produced crescendo episodes of expressive aphasia and mild right upper extremity weakness. Complete neurological recovery was achieved following emergent carotid embolectomy and endarterectomy. This case demonstrates that the laminar nature of internal carotid blood flow may result in the localization of embolic events to a single region of the cerebral vasculature, regardless of the source lesion in the carotid artery. The role of endoluminal techniques in the diagnosis and management of such lesions is discussed.
Geraghty
Patrick J
PJ
Department of Surgery, Section of Vascular Surgery, Washington University School of Medicine, 660 S. Euclid Avenue, Campus Box 8109, St. Louis, MO, 63110-1094, USA. geraghtyp@msnotes.wustl.edu
Oak
Jack
J
Choi
Eric T
ET
D000369:Aged, 80 and over; D000792:Angiography; D000925:Anticoagulants / Q000627:therapeutic use; D001281:Atrial Fibrillation / Q000150:complications; D002340:Carotid Artery Diseases / Q000000981:diagnostic imaging / Q000209:etiology* / Q000601:surgery; D016894:Endarterectomy, Carotid; D005260:Female; D006331:Heart Diseases / Q000209:etiology*; D006801:Humans; D020766:Intracranial Embolism / Q000209:etiology*; D002546:Ischemic Attack, Transient / Q000209:etiology*; D013927:Thrombosis / Q000209:etiology*
D000925:Anticoagulants