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Visual claudicatio: diagnosis with 64-slice computed tomography.

Filippo Cademartiri1, Erica Maffei, Alessandro Palumbo

  • 1Department of Radiology, Azienda Ospedaliero-Universitaria di Parma, Via Gramsci, 14, 43100, Parma, Italy. filippocademartiri@hotmail.com

The International Journal of Cardiovascular Imaging
|March 23, 2007
PubMed
Summary
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This case study highlights a 78-year-old male with visual claudication due to blocked carotid arteries. Multislice CT imaging proved optimal for diagnosing cerebrovascular circulation issues when ultrasound was insufficient.

Area of Science:

  • Vascular Neurology
  • Medical Imaging

Background:

  • Amaurosis fugax, or transient vision loss, can indicate serious underlying cerebrovascular disease.
  • Evaluating complex cerebrovascular anatomy and pathology requires advanced imaging techniques.

Observation:

  • A 78-year-old male presented with "visual claudication" (amaurosis fugax after minimal exertion).
  • Initial duplex ultrasound failed to visualize the carotid arteries.
  • Multislice computed tomography (CT) of the cerebrovascular circulation was performed.

Findings:

  • Complete occlusion of both common carotid arteries at their origin was identified.
  • Severe stenosis at the origin of both vertebral arteries was noted.
  • Collateral circulation via minor neck vessels and patent Circle of Willis arteries were visualized.

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Implications:

  • Multislice CT is a valuable tool for comprehensive cerebrovascular assessment, especially when ultrasound is inconclusive.
  • This case underscores the importance of investigating "visual claudication" to detect severe arterial occlusive disease.
  • Advanced CT imaging can reveal complex collateral pathways essential for brain perfusion in cases of significant stenosis or occlusion.