title: Cystic medionecrosis of the carotid bifurcation as an uncommon cause of stroke.
abstract: OBJECTIVE
  Cystic medionecrosis is characterized by degeneration of elastic and collagenous fibers in the media and predominantly involves the thoracic aorta. This rare disease is usually manifested clinically by a dissecting aneurysm. Cystic medionecrosis as a cause of moderate stenosis of the carotid artery in a patient having a stroke has not been reported.
  
  
  METHODS
  We report a case of a man who had a cerebral infarction caused by medium-degree stenosis of the left internal carotid artery. Duplex sonography and magnetic resonance imaging revealed no typical signs of dissection. The stenosis was caused by cystic medionecrosis that involved only the carotid bifurcation with microdissection, predominantly older intramural hemorrhage, and fresh intraluminal thrombotic deposits.
  
  
  CONCLUSIONS
  Patients with cystic medionecrosis may have a stroke due to short-track stenosis of the internal carotid artery.
authors.affiliation: Department of Neurology/Stroke Unit, SRH Wald-Klinikum in Gera, Teaching Hospital of the Friedrich-Schiller-University of Jena, Gera, Germany.
authors.forename: Kathrin
authors.initials: K
authors.lastname: Lesser
authors.forename: Carsten
authors.initials: C
authors.lastname: Boltze
authors.forename: Joachim
authors.initials: J
authors.lastname: Böttcher
authors.forename: Thomas G
authors.initials: TG
authors.lastname: Lesser
mesh_terms: D000784:Aortic Dissection / Q000000981:diagnostic imaging / Q000473:pathology; D017545:Aortic Aneurysm, Thoracic / Q000150:complications / Q000175:diagnosis / Q000503:physiopathology*; D002343:Carotid Artery, Internal / Q000000981:diagnostic imaging / Q000473:pathology*; D002544:Cerebral Infarction / Q000209:etiology*; D003560:Cysts / Q000150:complications / Q000175:diagnosis / Q000503:physiopathology*; D006801:Humans; D008297:Male; D008875:Middle Aged; D011859:Radiography; D018616:Ultrasonography, Doppler, Duplex / Q000379:methods