Concurrent cerebral and axillary artery occlusion: a possible source of cerebral embolization from peripheral artery thrombosis.
Intracranial embolization usually arises from heart, precerebral artery or aorta but rarely the peripheral artery as retrograde upstream of embolus should be overcome. We encountered a woman who experienced a transient right acronumbness followed by a sudden onset of left hemiplegia and conscious change concurrently. Cranial computerized tomography revealed a hemorrhagic infarct at right lentiform nucleus. Angiography disclosed right axillary artery occlusion at the proximal portion without collateral circulation. Cardioaortic survey and coagulation profile were normal. Thrombectomy was done and radial flow was corrected rapidly. Post-thrombectomic heparinization did not bring complication. Therefore, a distant embolism from peripheral artery at the upper limb should be alerted for cerebral ischemia. A lower density of embolus and no-flow condition in her occluded axillary artery may facilitate the upstreamed embolization. Heparinization, under closed monitor, is not contraindicated for preventing restenosis after thrombectomy in case of hemorrhagic transformation in brain.
Chen
Wei-Hsi
WH
Stroke Biology Research Laboratory, Department of Neurology, Chang Gung Memorial Hospital, Niao Sung Hsiang, Kaohsiung, Taiwan.
Chen
Shun-Sheng
SS
Liu
Jia-Shou
JS
D000369:Aged, 80 and over; D001157:Arterial Occlusive Diseases / Q000150:complications* / Q000175:diagnosis / Q000628:therapy; D001366:Axillary Artery; D002545:Brain Ischemia / Q000175:diagnosis / Q000209:etiology* / Q000628:therapy; D002536:Cerebral Arteries; D005260:Female; D006801:Humans; D020766:Intracranial Embolism / Q000175:diagnosis / Q000209:etiology* / Q000628:therapy