title: Mesothelioma and internal carotid artery occlusion: acute ischemic stroke and efficacy of emergency carotid thrombectomy.
abstract: We report the case of a 54-year-old man with acute stroke caused by left internal carotid artery (ICA) occlusion secondary to pleural mesothelioma, discovered later. The cranial computed tomography scan revealed a left hemisphere ischemic lesion. At neurological examination, the modified National Institutes of Health Stroke Scale (mNIHSS) score was 9. The carotid duplex scan (DS) showed a complete thrombotic occlusion of the left ICA. The patient underwent emergency carotid thrombectomy. The screening tests revealed thrombocytosis, hyperfibrinogenemia, increased C-reactive protein values, and multiple left pleural mesothelioma nodularity confirmed at the immunohistochemical investigation. After surgery, the patient's neurological symptoms improved, with an mNIHSS score of 3. At 30 and 120 days, the DS follow-up showed regular patency of the ICA.
authors.affiliation: Vascular and Endovascular Surgery Unit, Mauriziano Umberto I Hospital, Turin, Italy. emaferrero@libero.it
authors.forename: Emanuele
authors.initials: E
authors.lastname: Ferrero
authors.forename: Michelangelo
authors.initials: M
authors.lastname: Ferri
authors.forename: Andrea
authors.initials: A
authors.lastname: Viazzo
authors.forename: Andrea
authors.initials: A
authors.lastname: Gaggiano
authors.forename: Giuseppe
authors.initials: G
authors.lastname: Berardi
authors.forename: Salvatore
authors.initials: S
authors.lastname: Piazza
authors.forename: Pia
authors.initials: P
authors.lastname: Cumbo
authors.forename: Franco
authors.initials: F
authors.lastname: Nessi
mesh_terms: D002545:Brain Ischemia / Q000175:diagnosis / Q000209:etiology* / Q000601:surgery; D002343:Carotid Artery, Internal / Q000601:surgery*; D016893:Carotid Stenosis / Q000175:diagnosis / Q000209:etiology* / Q000601:surgery; D006801:Humans; D008297:Male; D008654:Mesothelioma / Q000150:complications* / Q000175:diagnosis / Q000628:therapy; D008875:Middle Aged; D009460:Neurologic Examination; D010975:Platelet Aggregation Inhibitors / Q000627:therapeutic use; D010997:Pleural Neoplasms / Q000150:complications* / Q000175:diagnosis / Q000628:therapy; D020521:Stroke / Q000175:diagnosis / Q000209:etiology* / Q000601:surgery; D017131:Thrombectomy; D013927:Thrombosis / Q000175:diagnosis / Q000209:etiology* / Q000601:surgery; D014057:Tomography, X-Ray Computed; D016896:Treatment Outcome; D018616:Ultrasonography, Doppler, Duplex
chemical_list: D010975:Platelet Aggregation Inhibitors