Intraluminal clot of the carotid artery detected radiographically

Caplan, L. R.; Stein, Russell; Patel, Deep; Amico, Lonnie L.; Cashman, N.; Gewertz, Bruce L.

doi:10.1212/wnl.34.9.1175

Cited by 57 publications

(40 citation statements)

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“…Moreover, when IDA is associated with stroke or a systemic embolism, large thrombi are sometimes present in an apparently intact carotid artery [3][4][5][6][7][8][9] as in our present case or less commonly in the aorta [10,11]. These patients are young women 20 -50 years of age with severe IDA (Hb 5.5 -10 g/dL), which is often caused by menorrhagia.…”

Section: Discussionsupporting

confidence: 52%

“…Moreover, several case reports suggest a causative role of IDA in young and otherwise healthy patients with stroke or with systemic embolism where thrombi are sometimes detected on an apparently intact arterial wall such as the carotid artery [3][4][5][6][7][8][9] or aorta [10,11]. Here we describe a patient with thrombi in an otherwise normal carotid artery and left ventricle, which is a previously unreported site for thrombosis in patients with IDA.…”

Section: Introductionmentioning

confidence: 74%

See 1 more Smart Citation

Simultaneous Thrombosis in a Normal Left Ventricle and Normal Carotid Artery in a Patient With a Stroke Secondary to Iron Deficiency Anemia

Nakamizo

2014

J Med Cases

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Iron deficiency anemia (IDA) is implicated as a cause of stroke, particularly in young patients without cardiovascular disease. In such patients, thrombi sometimes form in carotid arteries or the aorta. We report here a patient with a stroke secondary to IDA with thrombi in the normal left ventricle and normal carotid artery. The patient was a 45-year-old woman with severe IDA who developed cerebral infarction in the right middle cerebral artery. She had no other thrombophilia or cardiovascular diseases. Echocardiography showed a left ventricular thrombus without cardiac disease, and the carotid ultrasound showed a mobile thrombus attached to the right internal carotid artery without atherosclerosis. Antithrombotic therapy with iron supplementation removed both thrombi within 2 weeks. This is the first case of IDA with a ventricular thrombus in a normal heart. This case identifies a new site for thrombosis in IDA and shows that patients with IDA may present with simultaneous thrombosis at separate sites. IDA must therefore be recognized as a cause of stroke or systemic embolism, particularly in patients without detectable cardiovascular disease. In such patients, it is important to conduct careful investigations to detect thrombosis.

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Section: Discussionsupporting

confidence: 52%

Section: Introductionmentioning

confidence: 74%

Simultaneous Thrombosis in a Normal Left Ventricle and Normal Carotid Artery in a Patient With a Stroke Secondary to Iron Deficiency Anemia

Nakamizo

2014

J Med Cases

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“…Some small prospective series report similar effectiveness with heparin (and possibly even better results) as compared to emergency embolectomy. 1,3,4,[6][7][8] These reports differ from this one because (1) they refer to thrombi within the ICA, which may be exposed to different flow dynamics, and (2) most patients in these reports had underlying vessel wall abnormalities. Whether the extrapolation of the observations in these series to this patient would have been appropriate is, at best, uncertain.…”

Section: Discussionmentioning

confidence: 95%

Idiopathic Free-Floating Thrombus of the Common Carotid Artery

Silver

Gulka

Nicolle

et al. 2002

Can. j. neurol. sci.

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The unexpected detection of a common (CCA) or internal (ICA) carotid artery thrombus at angiography or carotid duplex ultrasonography (CUS) is unusual. [1][2][3][4] To our knowledge, no previous documentation of an apparent free-floating thrombus within the CCA alone exists. We report such a phenomenon in a 45-year-old woman. PATIENTA 45-year-old right-handed woman began having severe vomiting and diarrhea. During one of several trips to the bathroom, she was heard falling to the floor, and was found unable to move her right side. She presented to our hospital four hours after symptom onset. She had no recent illnesses and had not been taking any medications including hormone replacement therapy or birth control pills. Cerebrovascular risk factors included a 25-year, one pack per day smoking history and a family history of heart disease and stroke. Her initial vital signs were unremarkable. Her general examination was remarkable for a harsh, ABSTRACT: Background: The observation of an intraluminal common carotid artery thrombus overlying a wall defect at ultrasonography or angiography is unusual. To our knowledge, there are no previous reports of a free-floating thrombus in the common carotid artery. Case Report: A 45-year-old woman who was previously healthy and on no medications presented with acute hemiparesis and aphasia. Following testing that included carotid duplex and trancranial Doppler ultrasonography, diffusion-weighted magnetic resonance imaging, and digital subtraction angiography, the patient underwent emergency open embolectomy. No underlying wall defect was seen at the time of imaging or surgery. No obvious hypercoagulable state could be identified. Her NIH Stroke Scale score improved from 26 at admission to 2 at three months and 1 at one year. Conclusions: Multimodal imaging may have improved diagnosis and management in this patient with a unique finding. The source of the thrombus remains obscure.RÉSUMÉ: Thrombus flottant idiopathique de la carotide primitive. Introduction: Il est inusité d'observer un thrombus intraluminal au niveau d'une lésion de la paroi de la carotide primitive à l'échographie ou à l'angiographie. À notre connaissance, il n'existe pas de cas rapporté d'un thrombus flottant dans la carotide primitive. Histoire de cas: Une femme âgée de 45 ans, en bonne santé et ne prenant aucun médicament, a consulté pour une hémiparésie aiguë avec aphasie. Suite à une investigation comprenant un duplex carotidien, une échograplie Doppler transcrânienne, une résonance magnétique par diffusion pondérée et une angiographie digitalisée par soustraction, la patiente a subi une embolectomie ouverte d'urgence. Aucune lésion pariétale sous-jacente n'a été observée à l'imagerie ou à la chirurgie. Aucun problème d'hypercoagulabilité n'a été identifié. Son score au NIH stroke scale s'est amélioré, de 26 qu'il était à l'admission à 2 trois mois plus tard et à 1 après un an. Conclusions: L'imagerie multimodale a probablement aidé au diagnostic et au traitement de cette patiente porteuse d'une anomalie ...

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“…Since a CRS in patients without the conventional stroke etiology is characterized by the elevation of D-dimer levels and the presence of microembolic signals detected by transcranial Doppler, its etiological mechanism is mainly regarded as an embolism caused by hypercoagulopathy (1,4,5). In contrast, cases of a CRS that produces a thrombus in a large vessel have rarely been reported, and in most of them, cisplatin-based chemotherapy was administered (2,(6)(7)(8)(9)(10). Thrombus formation is assumed to be due to vascular toxicity associated with cisplatin, including induced endothelial damage and increased platelet aggregation (11), as well as hypercoagulopathy due to cancer itself.…”

Section: Discussionmentioning

confidence: 99%

“…In contrast, cases of CRS due to a large vessel thrombus have only rarely been reported. In most of them, cisplatin-based chemotherapy as well as cancer itself contributed to the thrombus formation (2,(6)(7)(8)(9)(10). We herein report a patient presenting with ischemic stroke due to a thrombus of the extracranial carotid artery complicating metastatic colorectal adenocarcinoma.…”

Section: Introductionmentioning

confidence: 91%

Cancer-related Stroke due to Mural Thrombus in the Extracranial Carotid Artery

et al. 2016

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A 41-year-old man was admitted to our hospital because of a cancer-related stroke (CRS) caused by a thrombus of the extracranial carotid artery. He had undergone neoadjuvant radiochemotherapy for metastatic colorectal adenocarcinoma. The serum D-dimer values were within the normal range. We treated him with intravenous unfractionated heparin followed by warfarin. There were no recurrent stroke events over six months. The leading cause of a CRS is an embolism caused by hypercoagulopathy, mainly represented by non-bacterial thrombotic endocarditis. However, it was unusual that, in the current case, a thrombus of the extracranial carotid artery was formed with no significant residual stenosis, thus resulting in an artery-toartery embolism.

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Intraluminal clot of the carotid artery detected radiographically

Cited by 57 publications

References 0 publications

Simultaneous Thrombosis in a Normal Left Ventricle and Normal Carotid Artery in a Patient With a Stroke Secondary to Iron Deficiency Anemia

Simultaneous Thrombosis in a Normal Left Ventricle and Normal Carotid Artery in a Patient With a Stroke Secondary to Iron Deficiency Anemia

Idiopathic Free-Floating Thrombus of the Common Carotid Artery

Cancer-related Stroke due to Mural Thrombus in the Extracranial Carotid Artery

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