title: Clopidogrel effective for frequent transient monocular blindness caused by vulnerable plaque.
abstract: Transient monocular blindness (TMB) is a well-known warning symptom of impending cerebral or retinal infarction, which suggests vulnerable ipsilateral carotid disease. Instability of free-floating thrombus may cause recurrent artery-to-artery embolism. A recent study showed that a combination of clopidogrel and aspirin might reduce microthromboembolisms. Here, we report a patient with frequent TMB despite aspirin monotherapy whose symptom disappeared after the addition of clopidogrel. This is the first report of aspirin-resistant frequent TMB caused by thromboembolism from vulnerable plaque that remitted after the addition of clopidogrel. These findings highlight the need for a randomized controlled trial to illustrate the most efficacious treatment strategy in this situation.
authors.affiliation: Department of Neurology, Seoul National University College of Medicine, Seoul National University Bundang Hospital, 300 Gumi-dong, Bundang-gu, Seongnam-si, Gyeonggi-do 463-707, Republic of Korea.
authors.forename: Hong-Kyun
authors.initials: HK
authors.lastname: Park
authors.forename: Hang Rai
authors.initials: HR
authors.lastname: Kim
authors.forename: Beom Joon
authors.initials: BJ
authors.lastname: Kim
authors.forename: Jihoon
authors.initials: J
authors.lastname: Kang
authors.forename: Cheolkyu
authors.initials: C
authors.lastname: Jung
authors.forename: Byung Se
authors.initials: BS
authors.lastname: Choi
authors.forename: Jae Hyoung
authors.initials: JH
authors.lastname: Kim
authors.forename: Moon-Ku
authors.initials: MK
authors.lastname: Han
authors.forename: Seong-Ho
authors.initials: SH
authors.lastname: Park
authors.forename: Hee-Joon
authors.initials: HJ
authors.lastname: Bae
mesh_terms: D015901:Angiography, Digital Subtraction; D001766:Blindness / Q000188:drug therapy* / Q000209:etiology*; D000077144:Clopidogrel; D006801:Humans; D018810:Magnetic Resonance Angiography; D008297:Male; D008875:Middle Aged; D058226:Plaque, Atherosclerotic / Q000150:complications*; D010975:Platelet Aggregation Inhibitors / Q000627:therapeutic use*; D013988:Ticlopidine / Q000031:analogs & derivatives* / Q000627:therapeutic use
chemical_list: D010975:Platelet Aggregation Inhibitors; D000077144:Clopidogrel; D013988:Ticlopidine
keywords: Clopidogrel loading; Free-floating thrombus; Transient monocular blindness; Vulnerable plaque