An Unusual Cause of Transient Neurologic Deficits: Compression of the Carotid Artery by a Thyroid Cystic Nodule
Received 21 July 2008; received in revised form 2 February 2009; accepted 11 February 2009.
We report a case of a 93-year-old man, who presented with limb-shaking transient ischemic attacks (TIAs) after orthostatic position change or turning his head to the left. The limb-shaking TIAs resulted from external compression of the carotid artery. Contrast-enhanced magnetic resonance angiography of the head and neck and Doppler ultrasound examination of the thyroid gland revealed a large cystic nodule in the right thyroid lobe, resulting in compression and posterior displacement of the right common carotid artery. Clinicians should be aware that limb-shaking TIAs can not only result from obstructive extracerebral or intracerebral artery disease, but also from external compression of the carotid artery.
∗Department of Neurology, Maastricht University Medical Center, Sittard, the Netherlands
†Department of Radiology, Maastricht University Medical Center, Sittard, the Netherlands
‡Department of Neurology, Maasland Hospital, Sittard, the Netherlands
Address correspondence to Hilde M. H. Braakman, MD, Department of Neurology, Maastricht University Medical Center, PO Box 5800, 6202 AZ Maastricht, the Netherlands.
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