Position Dependent Carotid Impingement Causing Recurrent Strokes.
We report the case of a young man with recurrent strokes over a four year period, all occurring after leaning forward. He had suffered damage to the right subclavian and right carotid arteries in a car accident 20 years prior. Review of history and imaging concluded that all of his infarcts had been in the distribution of the right carotid artery. CT angiogram revealed that a segment at the origin of the right common carotid artery was adjacent to the sternum and kinked at the point of contact. Proposed mechanism of infarcts is position dependent intermittent vessel damage causing thrombosis and distal embolization. The patient underwent surgical repair, with no further events. This case highlights the importance of evaluating structures adjacent to vessels in patients with cryptogenic strokes.
Department of Neurology, University of Maryland School of Medicine, Baltimore MD, USA.
Carolyn A
CA
Cronin1
Department of Radiology, University of Maryland School of Medicine, Baltimore MD, USA.
Manuel
M
Fortes
Department of Surgery, University of Maryland School of Medicine, Baltimore MD, USA.
Teng C
TC
Lee
Stroke; Stroke in Young Adults