scholarly journals A patient with right internal carotid artery territory infarctionduring intravenous recombinant tissue plasminogen activator treatment for left middle cerebral artery territory ischemic stroke

Nosotchu ◽  
2012 ◽  
Vol 34 (5) ◽  
pp. 351-355
Author(s):  
Hiroyuki Arakawa ◽  
Yasuhisa Akaiwa ◽  
Etsuji Saji ◽  
Takayoshi Shimohata ◽  
Masatoyo Nishizawa
Keyword(s):  
Ischemic Stroke ◽  
Carotid Artery ◽  
Internal Carotid Artery ◽  
Middle Cerebral Artery ◽  
Internal Carotid ◽  
Recombinant Tissue Plasminogen Activator ◽  
Left Middle Cerebral Artery ◽  
Middle Cerebral Artery Territory ◽  
Tissue Plasminogen ◽  
Left Middle

scholarly journals Mechanical thrombectomy utilising a collateral pathway in a patient with dysgenesis of the internal carotid artery

2018 ◽  
Vol 25 (1) ◽  
pp. 54-57
Author(s):  
Jun Tsukano ◽  
Satoshi Kurabe ◽  
Tsutomu Sugai ◽  
Manabu Wada ◽  
Takashi Kumagai
Keyword(s):  
Carotid Artery ◽  
Internal Carotid Artery ◽  
Middle Cerebral Artery ◽  
Cerebral Artery ◽  
Internal Carotid ◽  
Mechanical Thrombectomy ◽  
Left Middle Cerebral Artery ◽  
Collateral Pathway ◽  
Guiding Catheter ◽  
Left Middle

We describe a case of acute middle cerebral artery occlusion in a patient with ipsilateral internal carotid artery dysgenesis successfully treated with mechanical thrombectomy utilising a collateral pathway. During the procedure, a triaxial system using a balloon guiding catheter, flexible large lumen aspiration catheter and stent retriever was advanced from the left vertebral artery to the occluded left middle cerebral artery through the left posterior communicating artery. Because proximal aspiration from the balloon guiding catheter alone might have insufficient suction force due to the retrograde blood flow from large vascular communications (e.g. vertebral artery union), the tip of the flexible large lumen aspiration catheter was set at the proximal left middle cerebral artery, and distal aspiration was added during stent retrieval. A thrombolysis in cerebral infarction 2b result was achieved after the first pass. In this case, identification of carotid canal hypoplasia on computed tomography allowed for an immediate attempt of this alternative approach, avoiding a delay in the time to reperfusion.

scholarly journals A Case of Occlusive Radiation Vasculopathy Presenting as Bilateral Internal Carotid Artery, Left Middle Cerebral Artery Occlusion and Literature Review

2020 ◽  
Vol 12 (Suppl. 1) ◽  
pp. 91-96
Author(s):  
Yung-Chuan Huang ◽  
Shin-Leh Huang ◽  
Hon-Man Liu ◽  
Hou-Chang Chiu
Keyword(s):  
Carotid Artery ◽  
Literature Review ◽  
Internal Carotid Artery ◽  
Middle Cerebral Artery ◽  
Cerebral Artery ◽  
Internal Carotid ◽  
Tongue Cancer ◽  
Artery Occlusion ◽  
Left Middle Cerebral Artery ◽  
Left Middle

Radiation vasculopathy is one of the rare causes of ischemic stroke. Carotid stenosis with large volume infarction may occur years after radiation therapy for head or neck cancer. We report a case of a patient with bilateral internal carotid artery occlusion presenting with left middle cerebral artery infarct 10 years after receiving treatment for tongue cancer. A literature review and discussion of treatment for such patients are presented.

scholarly journals Luxury Perfusion Producing Sensory Aphasia

2021 ◽  
pp. 46-49
Author(s):  
Daiki Sakai ◽  
Ryuji Sakakibara ◽  
Fuyuki Tateno ◽  
Yosuke Aiba
Keyword(s):  
Brain Injury ◽  
Carotid Artery ◽  
Internal Carotid Artery ◽  
Middle Cerebral Artery ◽  
Internal Carotid ◽  
Left Middle Cerebral Artery ◽  
Sensory Aphasia ◽  
Luxury Perfusion ◽  
Old Japanese ◽  
Left Middle

We describe the case of an 86-year-old Japanese man who, by luxury perfusion after spontaneous recanalization of the left middle cerebral artery/internal carotid artery, produced acute transient sensory aphasia. This rare phenomenon is thought to be caused by reperfusion brain injury.

Intra-arterial Third-generation Recombinant Tissue Plasminogen Activator (Reteplase) for Acute Ischemic Stroke

Neurosurgery ◽  
2001 ◽  
Vol 49 (1) ◽  
pp. 41-50 ◽  
Author(s):  
Adnan I. Qureshi ◽  
Zulfiqar Ali ◽  
M. Fareed K. Suri ◽  
Stanley H. Kim ◽  
Ahmed A. Shatla ◽  
...  
Keyword(s):  
Ischemic Stroke ◽  
Carotid Artery ◽  
Internal Carotid Artery ◽  
Intracerebral Hemorrhage ◽  
Internal Carotid ◽  
Recombinant Tissue Plasminogen Activator ◽  
National Institutes Of Health ◽  
Third Generation ◽  
Timi Grade ◽  
Tissue Plasminogen

Abstract OBJECTIVE We prospectively evaluated the safety and recanalization efficacy of intra-arterially administered reteplase, a third-generation recombinant tissue plasminogen activator, for treating ischemic stroke in patients considered poor candidates for intravenously administered alteplase therapy. METHODS Patients were considered poor candidates for intravenously administered therapy because of severity of neurological deficits, interval from onset of symptoms to presentation of 3 hours or more, or recent major surgery. We administered a maximum total dose of 8 U of reteplase intra-arterially in 1-U increments via superselective catheterization. Adjunctive angioplasty of the occluded artery was performed in seven patients. Angiographic evidence of perfusion and thrombus was graded by use of modified Thrombolysis in Myocardial Infarction (TIMI) criteria. Neurological examinations were performed before and 24 hours and 7 to 10 days after treatment. RESULTS Sixteen consecutive patients were treated (mean age, 64.1 ± 16.4 yr; seven were men). Initial National Institutes of Health Stroke Scale scores ranged from 10 to 26. Time from onset of symptoms to treatment ranged from 2 to 9 hours. Occlusion sites were the cervical internal carotid artery (n = 4), intracranial internal carotid artery (n = 4), middle cerebral artery (n = 6), and vertebrobasilar artery (n = 2). Complete or near-complete perfusion (TIMI Grade 3 or 4) was achieved in the arteries in 14 patients (88%), with partial recanalization (TIMI Grade 2) or minimal response (TIMI Grade 1) in the arteries in one patient each. Neurological improvement (defined as decrease of four or more points in National Institutes of Health Stroke Scale score) was observed in 7 (44%) of the 16 patients at 24 hours. Symptomatic intracerebral hemorrhage occurred in one patient; three other patients experienced intracerebral hemorrhages that did not result in neurological worsening. The overall mortality during hospitalization was 56%, related to massive ischemic stroke (n = 7), withdrawal of care at the family's request after the development of aspiration pneumonia and renal failure (n = 1), and a combination of intracerebral hemorrhage and massive ischemic stroke (n = 1). CONCLUSION In this study, intra-arterially administered reteplase in doses up to 8 U with or without angioplasty resulted in a high rate of recanalization. This strategy should be considered in treating patients considered poor candidates for intravenous thrombolysis.

Emergent Carotid Thromboendarterectomy for Acute Symptomatic Occlusion of the Extracranial Internal Carotid Artery

2017 ◽  
Vol 51 (4) ◽  
pp. 176-182 ◽  
Author(s):  
Igor Gunka ◽  
Dagmar Krajickova ◽  
Michal Lesko ◽  
Stanislav Jiska ◽  
Jan Raupach ◽  
...  
Keyword(s):  
Ischemic Stroke ◽  
Carotid Artery ◽  
Internal Carotid Artery ◽  
Internal Carotid ◽  
Intravenous Thrombolysis ◽  
Recombinant Tissue Plasminogen Activator ◽  
Time Interval ◽  
Nihss Score ◽  
Carotid Revascularization ◽  
Extracranial Ica

Background: Strokes secondary to acute internal carotid artery (ICA) occlusion are associated with an extremely poor prognosis. The best treatment approach in this setting is still unknown. The aim of our study was to evaluate the efficacy, safety, and outcomes of emergent surgical revascularization of acute extracranial ICA occlusion in patients with minor to severe ischemic stroke. Methods: A retrospective analysis was performed using prospectively collected data of consecutive patients who underwent carotid thromboendarterectomy for symptomatic acute ICA occlusion during the period from January 2013 to December 2015. Primary outcomes were disability at 90 days assessed by the modified Rankin Scale (mRS) and neurological deficit at discharge assessed using the National Institute of Health Stroke Scale (NIHSS). Secondary outcomes were the recanalization rate, 30-day overall mortality, and any intracerebral bleeding. Results: During the study period, a total of 6 patients (5 men and 1 woman) with a median age of 64 years (range: 58-84 years) underwent emergent reconstruction for acute symptomatic ICA occlusion within a median of 5.4 hours (range: 2.9-12.0 hours) after symptoms onset. The median presenting NIHSS score was 10.5 points (range: 4-21). Before surgery, 4 patients (66.7%) had been treated by systemic recombinant tissue plasminogen activator lysis. The median time interval between initiation of intravenous thrombolysis and carotid thromboendarterectomy was 117.5 minutes (range: 65-140 minutes). Patency of the ICA was achieved in all patients. On discharge, the median NIHSS score was 2 points (range: 0-11 points). There was no postoperative intracerebral hemorrhage and zero 30-day mortality rate. At 3 months, 5 patients (83.3%) had a good clinical outcome (mRS ≤ 2). Conclusion: Patients presenting with minor to severe ischemic stroke syndromes due to isolated extracranial ICA occlusion may benefit from emergent carotid revascularization. Thorough preoperative neuroimaging is essential to aid in selecting eligible candidates for acute surgical intervention.

scholarly journals Left internal carotid artery agenesis in a patient with headache

2014 ◽  
pp. 25-27
Author(s):  
Inês Alice Teixeira Leão ◽  
C. H. Rezende ◽  
J. B. L. Gomes ◽  
R. F. Almeida
Keyword(s):  
Computed Tomography ◽  
Carotid Artery ◽  
Internal Carotid Artery ◽  
Rare Case ◽  
Internal Carotid ◽  
Left Internal Carotid Artery ◽  
Left Middle Cerebral Artery ◽  
Clinical Neurology ◽  
Structural Lesion ◽  
Left Middle

Sometimes in clinical neurology, we diagnose a very rare case. We report on a patient who presented with crisis of headache and vomiting (clinically diagnose as migraine). Computed tomography (CT) scan of the head did not reveal any structural lesion. Magnetic resonance angiography showed absence of left internal carotid artery associated with absence of the left middle cerebral artery (MCA).

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