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A case of internal carotid thrombus associated with brain infarction

Shota Sakai1, Takeshi Uwatoko, Koji Ishitsuka

  • 1Department of Cerebrovascular Medicine, Saga-ken Medical Centre Koseikan.

Rinsho Shinkeigaku = Clinical Neurology
|December 28, 2016
PubMed

Insights

Anticoagulant therapy effectively resolved a large internal carotid artery thrombus causing stroke symptoms. Carotid ultrasonography confirmed the thrombus disappearance, highlighting its utility in monitoring treatment effectiveness for internal carotid thrombus.

Area of Science:

  • Neurology
  • Vascular Medicine

Background:

  • Cerebral infarction presents with neurological deficits.
  • Large internal carotid artery thrombi pose a significant stroke risk.

Observation:

  • A 49-year-old male presented with global aphasia and right-sided hemiparesis.
  • Brain MRI revealed acute cerebral infarction in the left anterior and middle cerebral artery territories.
  • Magnetic resonance angiography demonstrated occlusion of the A2 and M2 segments.
  • A giant left internal carotid artery thrombus (6 × 7 × 17 mm) was identified via carotid ultrasonography.
  • Intravenous tissue plasminogen activator (t-PA) administration did not improve symptoms.

Findings:

  • Anticoagulant therapy led to gradual miniaturization and eventual disappearance of the internal carotid artery thrombus.
  • Carotid ultrasonography proved effective in monitoring thrombus resolution.

Implications:

  • Anticoagulant therapy is a viable and effective treatment for internal carotid artery thrombus.
  • Carotid ultrasonography is a valuable tool for assessing treatment efficacy in such cases.
  • Clinicians should consider anticoagulant therapy as a primary treatment for internal carotid thrombus.

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