Spontaneous early recanalization of an acute symptomatic critical stenosis of the extracranial internal carotid artery: a case report.
We present a 63-year-old female with critical stenosis of the extracranial portion of the internal carotid artery (ICA), diagnosed using color-coded Duplex ultrasonography (CCDU) and magnetic resonance imaging. Nine days later, the patient showed profound clinical improvement, at which time spontaneous recanalization of the previously highly stenosed ICA was seen in follow-up CCDU and magnetic resonance angiography (MRA) and confirmed by three-dimensional computed tomography angiography (CTA). The detection of recanalization is important in predicting the patient's prognosis and deciding a suboptimal secondary prophylaxis strategy of medical or surgical treatment. Therefore, we suggest performing imaging studies immediately in patients, especially potential surgical or stenting candidates showing great changes in neurological function, through examination with CCDU and confirmation with MRA or CTA, all safe and minimally invasive methods, to see whether recanalization has occurred.
Yang
Fu-Chi
FC
Department of Neurology, Tri-Service General Hospital, National Defense Medical Center, Taipei, Taiwan, ROC. fuji-yang@yahoo.com.tw
Lin
Jiann-Chyun
JC
Chen
Cheng-Yu
CY
Peng
Giia-Sheun
GS
D000208:Acute Disease; D002343:Carotid Artery, Internal / Q000473:pathology* / Q000503:physiopathology; D016893:Carotid Stenosis / Q000150:complications / Q000473:pathology* / Q000503:physiopathology / Q000628:therapy; D002533:Cerebral Angiography; D002544:Cerebral Infarction / Q000209:etiology* / Q000473:pathology / Q000503:physiopathology / Q000628:therapy; D002560:Cerebrovascular Circulation; D016638:Critical Illness; D004401:Dysarthria / Q000209:etiology / Q000473:pathology; D005260:Female; D006429:Hemiplegia / Q000209:etiology / Q000473:pathology; D006801:Humans; D018810:Magnetic Resonance Angiography; D008875:Middle Aged; D018579:Patient Selection; D011379:Prognosis; D012075:Remission, Spontaneous; D013997:Time Factors; D014057:Tomography, X-Ray Computed; D018615:Ultrasonography, Doppler, Color; D014654:Vascular Patency