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Cerebral atheromatous embolism following carotid sinus pressure
Insights
Carotid sinus pressure can rarely cause stroke. A case report shows an atheromatous embolus caused a stroke after carotid sinus pressure, suggesting this is a likely mechanism for such events.
Area of Science:
- Neurology
- Cardiology
- Pathology
Background:
- Carotid sinus pressure is a maneuver used in clinical practice.
- Potential complications include cardiac arrhythmias and cerebrovascular accidents, though rare.
Observation:
- A 79-year-old male developed sudden right hemiplegia within one minute of left carotid sinus pressure.
- Necropsy revealed an atheromatous embolus obstructing the left middle cerebral artery.
Findings:
- The patient's stroke was a hemorrhagic infarction in the territory supplied by the left middle cerebral artery.
- This represents the first documented case of atheromatous embolism secondary to carotid sinus pressure.
Implications:
- Atheromatous embolism is a likely cause of sudden stroke deficits following carotid sinus pressure.
- This finding may influence clinical practice and patient risk assessment.
Abstract:
Complications of carotid sinus pressure, which are rare, include cardiac arrhythmias and cerebrovascular accidents. A 79-year-old man experienced a flaccid right hemiplegia one minute after left carotid sinus pressure. At necropsy, an atheromatous embolus occluded the left middle cerebral artery, resulting in hemorrhagic infarction in its vascular territory. Atheromatous embolism following carotid sinus pressure has not been previously documented. Most sudden stroke deficits following carotid sinus pressure are probably caused by this mechanism.