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Stroke secondary to multiple spontaneous cholesterol emboli.

M Pascual¹, J M Baumgartner, H Bounameaux

¹Department of Medicine, University Hospital of Geneva, Switzerland.

VASA. Zeitschrift Fur Gefasskrankheiten

|January 1, 1991

Summary

A 49-year-old diabetic patient experienced a stroke due to cholesterol emboli from a carotid artery plaque. This case highlights a rare presentation of atheroembolic disease, emphasizing the potential for stroke.

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Area of Science:

Neurology
Cardiovascular Medicine
Pathology

Background:

Cholesterol embolization syndrome (CES) typically presents with renal failure, hypertension, and skin ulcerations, primarily associated with atheromatous aortic disease.
Cerebral involvement, specifically stroke, is an uncommon manifestation of CES.

Observation:

A 49-year-old diabetic male presented with regressive stroke, aphasia, and right-sided hemiparesis.
Cerebral emboli in the left paraventricular cortex were identified, alongside cholesterol emboli in the left eye ground.
An atheromatous plaque was detected at the ipsilateral carotid bifurcation.

Findings:

The cerebral emboli were presumed to be cholesterol crystals originating from the carotid plaque.
Neurologic improvement occurred after treatment with low-dose aspirin (100 mg/day).

Related Experiment Videos

One-year follow-up showed clinical stability, recurrent retinal cholesterol emboli, and an unchanged carotid plaque.

Implications:

This case underscores that stroke can be a rare but significant manifestation of cholesterol embolization syndrome.
Increased use of invasive vascular procedures may lead to a higher incidence of such embolic events.
Further research is warranted to understand and prevent cerebral complications of atheroembolic disease.