학술논문

Endovascular treatment of acute intracranial large-vessel occlusion caused by a thrombus in the cervical internal carotid artery / 頚部内頚動脈内血栓に起因した急性頭蓋内主幹動脈閉塞に対する血管内治療の1例
Document Type
Journal Article
Source
NEUROSURGICAL EMERGENCY. 2022, 27(2):153
Subject
carotid T occlusion
internal carotid artery occlusion
mechanical thrombectomy
middle cerebral artery occlusion
migration of thrombus
Language
Japanese
ISSN
1342-6214
2434-0561
Abstract
We describe a case in which a cardiogenic thrombus at the cervical internal carotid artery migrated to the middle cerebral artery. The patient was a 69‒year‒old female who had mild neurological symptoms. At her first visit, magnetic resonance diffusion‒weighted imaging indicated no acute ischemic lesion. Magnetic resonance angiography revealed occlusion of the right internal carotid artery and a patent middle cerebral artery supplied via the posterior communicating artery. The next day, the patient exhibited left hemiparesis and occlusion of both the internal carotid artery and middle cerebral artery. A mechanical thrombectomy was performed. Complete recanalization was achieved, and the patient’s neurological deficits were resolved. The mechanical thrombectomy was effective for this emergency state of thrombus migration from the cervical internal carotid artery to the terminus of the internal carotid artery. The present case demonstrates that it is possible for a thrombus of the cervical internal carotid artery to migrate to a distal intracranial artery and result in severe symptoms. In the event of such an emergency, a system for rapid treatment by mechanical thrombectomy is needed.

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