title: Stroke from an External Carotid: Lesion Pattern and Mechanisms.
abstract: Traditionally, patients with symptomatic external carotid stenosis present with neck or face pain, retinal ischemic symptoms or jaw claudication and rarely as ipsilateral cerebrovascular events. In this present case, our patient suffered a stroke from a paradoxical embolism from the external carotid, without involvement of the internal carotid artery. A plaque ulceration of the external carotid's origin was the cause of this cerebral emboli. Duplex ultrasound showed a pathologic left external carotid, with a floating thrombus in the internal carotid. The diagnostic was confirmed by a computerized tomography scan. An external carotid thromboendarterectomy was performed 6 days after symptom onset, and intraoperative findings confirmed the plaque rupture with an extensive clot in the carotid bifurcation.
authors.affiliation: Vascular Surgery Department, Assistance Publique-Hôpitaux de Paris (AP-HP), Pitié-Salpêtrière University Hospital, Pierre & Marie Curie University, Paris, France; Vascular Surgery Department, CHRU Trousseau, Tours, France. Electronic address: nicolas.kagan@gmail.com.
authors.forename: Kagan
authors.initials: K
authors.lastname: Nicolas
authors.affiliation: Vascular Surgery Department, CHRU Trousseau, Tours, France.
authors.forename: Lathelyse
authors.initials: L
authors.lastname: Hubert
authors.affiliation: Department of Plastic & Reconstructive Surgery, Burn Surgery, Hand Surgery, CHU University of Bordeaux, Centre François-Xavier-Michelet, Groupe hospitalier Pellegrin, Place Amèlie-Raba-Lèon, 33076 Bordeaux, France; Department of Anatomy, University of Bordeaux, 33076 Bordeaux, France.
authors.forename: Franck Marie
authors.initials: FM
authors.lastname: Leclère
authors.affiliation: Vascular Surgery Department, CHRU Trousseau, Tours, France.
authors.forename: Marchand
authors.initials: M
authors.lastname: Etienne
authors.affiliation: Vascular Surgery Department, CHRU Trousseau, Tours, France.
authors.forename: Martinez
authors.initials: M
authors.lastname: Robert
mesh_terms: D000368:Aged; D002342:Carotid Artery, External / Q000000981:diagnostic imaging / Q000601:surgery; D002343:Carotid Artery, Internal / Q000000981:diagnostic imaging / Q000601:surgery; D016893:Carotid Stenosis / Q000150:complications* / Q000000981:diagnostic imaging / Q000601:surgery; D000072226:Computed Tomography Angiography; D016894:Endarterectomy, Carotid; D006801:Humans; D020766:Intracranial Embolism / Q000000981:diagnostic imaging / Q000209:etiology*; D018810:Magnetic Resonance Angiography; D008297:Male; D020521:Stroke / Q000000981:diagnostic imaging / Q000209:etiology*; D017131:Thrombectomy; D018608:Ultrasonography, Doppler