Spontaneous recanalization of a middle cerebral artery occlusion with subsequent carotid endarterectomy.
We report the case of a 55-year-old man who presented with a left hemisphere stroke. The initial computed tomography scan demonstrated a cerebral infarct in association with a left middle cerebral artery occlusion. Carotid duplex ultrasound imaging revealed a surgical grade stenosis of the proximal left internal carotid artery; however, in view of the uncertain benefits of internal carotid endarterectomy in the face of ipsilateral middle cerebral artery occlusion, surgery was deferred. Subsequent surveillance by transcranial Doppler imaging and repeat computed tomography demonstrated spontaneous recanalization. The patient proceeded to carotid endarterectomy with no complications.
Ayr District General Hospital, Ayr, United Kingdom.
Andrew J
AJ
Jackson
Amit
A
Patel
Bryce
B
Renwick
Mark
M
Ablett
Ian
I
McMillan
D016893:Carotid Stenosis / Q000150:complications / Q000175:diagnosis / Q000503:physiopathology / Q000601:surgery*; D002533:Cerebral Angiography / Q000379:methods; D002560:Cerebrovascular Circulation; D016894:Endarterectomy, Carotid; D006801:Humans; D020244:Infarction, Middle Cerebral Artery / Q000175:diagnosis / Q000188:drug therapy* / Q000209:etiology / Q000503:physiopathology; D008297:Male; D008875:Middle Aged; D010975:Platelet Aggregation Inhibitors / Q000627:therapeutic use*; D011673:Pulsatile Flow; D012039:Regional Blood Flow; D012720:Severity of Illness Index; D020521:Stroke / Q000175:diagnosis / Q000188:drug therapy* / Q000209:etiology / Q000503:physiopathology; D014057:Tomography, X-Ray Computed; D016896:Treatment Outcome; D018616:Ultrasonography, Doppler, Duplex; D017585:Ultrasonography, Doppler, Transcranial; D014654:Vascular Patency
D010975:Platelet Aggregation Inhibitors