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Aortogenic calcified cerebral embolism diagnosed with an embolus retrieved by thrombectomy: illustrative case

Yasunori Yokochi1, Hiroyuki Ikeda1, Mai Tanimura1

  • 1Department of Neurosurgery, Kurashiki Central Hospital, Kurashiki, Japan

Journal of Neurosurgery. Case Lessons
|April 1, 2024
PubMed

Insights

A rare case of aortogenic calcified cerebral embolism causing acute cerebral infarction was identified. This study highlights the aorta as a potential source of calcified emboli, even with known cardiac conditions.

Area of Science:

  • Neurology
  • Cardiology
  • Pathology

Background:

  • Calcified cerebral embolism is a known cause of acute cerebral infarction.
  • An aortogenic origin for such emboli is rarely identified.
  • This study presents a case of aortogenic calcified cerebral embolism.

Purpose of the Study:

  • To describe a case of aortogenic calcified cerebral embolism.
  • To highlight the aorta as a potential embolic source in cerebral infarction.
  • To emphasize the diagnostic value of embolus analysis.

Main Methods:

  • Mechanical thrombectomy was performed to retrieve a cerebral embolus.
  • Pathological analysis of the retrieved embolus was conducted.
  • Macroscopic and histological examination of the embolus.

Main Results:

  • A white, hard embolus was retrieved from a patient with cerebral infarction and atrial fibrillation.
  • Pathological analysis revealed the embolus was predominantly calcified, with foam cells and giant cells.
  • Diagnosis of aortogenic calcified cerebral embolism was established.

Conclusions:

  • Aortic atheroma with calcification can be an embolic source for cerebral infarction.
  • This diagnosis is possible even in patients with known cardiogenic embolic sources.
  • Macroscopic and pathological findings of retrieved emboli are crucial for identifying the source.
Abstract

Keywords:
aortogenic emboluscalcified cerebral embolusmacroscopic findingpathologythrombectomy

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