EXTRACRANIAL CAROTID ARTERY ANEURYSM: A RARE CAUSE OF ISCHEMIC STROKE

Download or read book EXTRACRANIAL CAROTID ARTERY ANEURYSM: A RARE CAUSE OF ISCHEMIC STROKE written by Guy Leseche and published by . This book was released on 2017 with total page pages. Available in PDF, EPUB and Kindle. Book excerpt: Background and objective: Extracranial carotid artery aneurysms (ECAAs) are a rare cause of ischemic stroke or transient ischemic attack. We report the case of a patient and we aimed at discussing the presentation, the etiologies, the diagnostic methods and the treatment of these aneurysms.Case: A 77 year old man was hospitalized because of sudden left hemiparesis and dysarthria. These symptoms appeared immediately after he rubbed a right anterior cervical mass he had since three months. Brain imaging revealed an ischemic stroke in the right middle cerebral artery and the MR angiography (figure 1) showed a large right internal carotid artery aneurysm (13x15x19mm) with intraluminal thrombus. A positron emission tomography scanner (figure 2) was performed but didnu2019t showed significant carotid or other location of hypermetabolism. Biological data (with serological and immunological tests) were normal. An anticoagulant therapy was started and chirurgical treatment with endarterectomy was performed at 24 hours after the patientu2019s admission. He totally recovered. Anatomopathological study of the lesion identified fibromuscular dysplasia.Discussion: ECAAS could be symptomatic (ischemic stroke, transient ischemic attack, painless masses, dysphagia or rupture) or asymptomatic. Etiologies include atherosclerosis (the most common), fibromuscular dysplasia, infection, trauma or connective tissue diseases. Their treatment is usually open surgery or endovascular intervention. Conclusions: This unusually cause of ischemic stroke need to be identified because of the particularities of the underlying etiologies and their specific treatment.