Related Experiment Video
Updated: Mar 29, 2026
Creation of Two Saccular Elastase-Digested Aneurysms with Different Hemodynamics in One Rabbit
Published on: April 15, 2021
Carotid stump syndrome: A case report
X U Zhang1, Shixiu Shao2, Xueping Zheng1
1Department of Neurology, The Affiliated Hospital of Qingdao University, Qingdao, Shandong 266000, P.R. China.
Insights
Carotid stump syndrome can cause recurrent ischemic stroke. This case study shows microemboli from the internal carotid artery stump caused a retinal artery embolism, successfully treated with anticoagulation.
Area of Science:
- Neurology
- Vascular Surgery
- Ophthalmology
Background:
- Carotid stump syndrome (CSS) is a recognized cause of recurrent ipsilateral ischemic stroke after internal carotid artery (ICA) occlusion.
- Microemboli originating from the occluded ICA stump can lead to ischemic events.
Purpose of the Study:
- To describe a case of left CSS presenting as central retinal artery embolism.
- To explore the pathophysiology of CSS-induced retinal artery embolism via anastomotic channels.
- To report the treatment outcome for this CSS case.
Main Methods:
- Case report of a 50-year-old patient with left CSS and central retinal artery embolism.
- Digital subtraction angiography to visualize ICA stump flow and potential anastomotic channels.
- Evaluation of potential pathophysiological mechanisms for emboli transport.
Main Results:
- The patient presented with central retinal artery embolism secondary to left ICA and middle cerebral artery occlusion.
- Angiography revealed trickle flow in the occluded ICA, suggesting a pathway for emboli to the ophthalmic artery via external carotid-internal carotid anastomoses.
- Successful treatment was achieved with anticoagulation therapy alone.
Conclusions:
- CSS can manifest as retinal artery embolism due to microemboli from the ICA stump.
- External carotid-internal carotid anastomotic channels may facilitate emboli transport to the ophthalmic artery.
- Anticoagulation therapy can be an effective treatment for CSS-related retinal artery embolism.
Abstract:
Carotid stump syndrome (CSS) is known to be one of the causes of recurrent ipsilateral ischemic stroke following the occlusion of the internal carotid artery (ICA). The present study describes a case of left CSS in a 50-year-old patient presenting with a central retinal artery embolism following internal carotid and middle cerebral artery occlusion. The central retinal artery embolism was believed to be a consequence of microemboli, which originated from the stump of the occluded ICA, passing into the ophthalmic artery due to external carotid-internal carotid anastomotic channels, although the other possible pathophysiological causes of this condition are discussed. Digital subtraction angiography of the patient showed trickle flow in the occluded ICA during the venous phase, by which the stump emboli may have been transported to the ophthalmic artery. The patient was successfully treated with anticoagulation therapy without surgical or endovascular treatment.
More Related Videos
05:32Author Spotlight: Assessing Ischemic Stroke Damage Through Middle Cerebral Artery Occlusion Model
Published on: August 11, 2023
09:36A Magnetic Resonance Imaging-based Computational Protocol for Analysis of Plaque Morphology and Hemodynamics in Patients with Carotid Artery Stenosis
Published on: August 12, 2025