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Bilateral Common Carotid Artery Occlusion as an Adequate Preconditioning Stimulus to Induce Early Ischemic Tolerance to Focal Cerebral Ischemia
Published on: May 9, 2013
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Unilateral Carotid Rete Mirabile Presenting with Limb-Shaking Transient Ischemic Attack
Jian Wang1, Hongbo Zheng1, Fayun Hu1
1Department of Neurology, West China Hospital of Sichuan University, Chengdu, Sichuan, China.
World Neurosurgery
|November 6, 2024
Summary
A rare case of carotid rete mirabile (RM) mimicked carotid artery stenosis, causing limb-shaking transient ischemic attacks. Conservative management with antiplatelet therapy proved effective, highlighting RM as a crucial differential diagnosis.
Area of Science:
- Neurology
- Vascular Neurology
- Neuroimaging
Background:
- Limb-shaking transient ischemic attacks (TIA) are typically linked to significant carotid artery stenosis.
- Carotid rete mirabile (RM) is a rare vascular anomaly that can present atypically.
Purpose of the Study:
- To report a rare case of unilateral carotid rete mirabile (RM) presenting as limb-shaking TIAs.
- To emphasize the importance of considering RM in the differential diagnosis of TIAs mimicking carotid stenosis.
Main Methods:
- A 70-year-old male presented with recurrent limb shaking and numbness.
- Cerebral angiography revealed a unilateral carotid rete mirabile.
- Computed tomography identified carotid canal dysplasia, supporting the RM diagnosis.
Main Results:
- The patient's angiography demonstrated an anomalous microarterial collateral network replacing the right internal carotid artery's cavernous segment, consistent with RM.
- Differential diagnoses considered included recanalization after occlusion and arteriovenous malformation.
- The patient experienced no further cerebrovascular events after initiating antiplatelet therapy and lifestyle modifications.
Conclusions:
- Carotid rete mirabile (RM) should be considered in the differential diagnosis of limb-shaking TIAs, even in the absence of typical carotid stenosis.
- Conservative management, including antiplatelet therapy, may be a favorable approach for patients with RM presenting with TIAs.
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