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Carotid floating plaques associated with multiple cerebral embolic strokes. Case reports
Angiology
|March 1, 1997
Summary
Artery-to-artery emboli from carotid plaques caused multiple strokes in two patients. Antiplatelet therapy led to recovery and resolution of emboli, highlighting this treatment
Area of Science:
- Neurology
- Vascular Surgery
- Radiology
Background:
- Cerebral infarcts and hemorrhagic transformation can result from embolic events.
- Identifying the source of emboli is crucial for effective stroke prevention.
Observation:
- Two patients presented with multiple cerebral infarcts and hemorrhagic transformation.
- Duplex sonography revealed ulcerated carotid plaques with free-floating thrombus at the carotid bifurcation.
- One patient experienced an occipital infarction attributed to emboli traversing a fetal-type posterior communicating artery.
Findings:
- Artery-to-artery emboli originating from the carotid bifurcation were identified as the cause of stroke.
- No alternative embolic sources were detected.
- Antiplatelet treatment resulted in successful recovery without recurrent stroke or transient ischemic attack.
- Follow-up imaging demonstrated thrombus resolution or lesion consolidation.
Implications:
- Carotid artery plaque with thrombus is a significant source of artery-to-artery emboli causing cerebral infarction.
- Antiplatelet therapy is effective in managing such cases and preventing recurrence.
- Duplex sonography is valuable for diagnosing carotid artery embolism.