Advertisement
Case Report| Volume 24, ISSUE 8, e201-e204, August 2015

Bilateral Atherosclerotic Internal Carotid Artery Occlusion with Intact Cerebral Glucose Metabolism: A Case Report

      Background

      Mild neurologic deficits concomitant with bilateral internal carotid artery occlusion (BICAO) is very rare and its treatment is still unclear.

      Case Report

      Herein, we report a case of a 67-year-old man with BICAO. The collateral circulation was rich, the symptoms were mild, and only standard pharmacotherapy was prescribed. Follow-up Mini-Mental State Examination, fluorine-18-fluorodeoxyglucose positron emission tomography, and magnetic resonance perfusion-weighted imaging were performed for 6 months.

      Results

      The results showed uniform reduction in perfusion throughout the brain, normal glucose uptake by the brain, and no ischemic events and cognitive impairment during the follow-up period.

      Conclusions

      For BICAO patients who are with mild neurologic deficits and good cerebral collateral and metabolism, the timely administration of pharmacotherapy might be safe and effective. Thus, in our patient, a favorable prognosis was achieved, but further follow-up is still required.

      Key Words

      To read this article in full you will need to make a payment

      Purchase one-time access:

      Academic & Personal: 24 hour online accessCorporate R&D Professionals: 24 hour online access
      One-time access price info
      • For academic or personal research use, select 'Academic and Personal'
      • For corporate R&D use, select 'Corporate R&D Professionals'

      Subscribe:

      Subscribe to Journal of Stroke and Cerebrovascular Diseases
      Already a print subscriber? Claim online access
      Already an online subscriber? Sign in
      Institutional Access: Sign in to ScienceDirect

      References

        • AbuRahma A.F.
        • Copeland S.E.
        Bilateral internal carotid artery occlusion: natural history and surgical alternatives.
        Cardiovasc Surg. 1998; 6: 579-583
        • Rutgers D.R.
        • van Osch M.J.
        • Kappelle L.J.
        • et al.
        Cerebral hemodynamics and metabolism in patients with symptomatic occlusion of the internal carotid artery.
        Stroke. 2003; 34: 648-652
        • Hanaoka K.
        • Hosono M.
        • Shimono T.
        • et al.
        Decreased brain FDG uptake in patients with extensive non-Hodgkin's lymphoma lesions.
        Ann Nucl Med. 2010; 24: 707-711
        • Alurkar A.
        • Karanam L.S.
        • Oak S.
        • et al.
        Endovascular treatment of ruptured wide-necked-basilar tip aneurysm with Y stenting and coiling in a case of bilateral internal carotid artery occlusion with moyamoya disease.
        Neurol India. 2012; 60: 449-450
        • Yoshida S.
        • Eguchi K.
        • Onodera K.
        • et al.
        Bilateral internal carotid artery occlusion and severe basilar artery stenosis in a patient with fibromuscular dysplasia: a case report.
        Rinsho Shinkeigaku. 2013; 53: 439-445
        • Prefasi D.
        • Martínez-Sánchez P.
        • Fuentes B.
        • et al.
        Bilateral carotid occlusion and progressive stenosis of vertebral arteries after radiotherapy in a young patient.
        Neurologia. 2012; 27: 122-124
        • Xu K.
        • Wang H.
        • Luo Q.
        • et al.
        Endovascular treatment of bilateral carotid artery occlusion with concurrent basilar apex aneurysm: a case report and literature review.
        Int J Med Sci. 2011; 8: 263-269
        • Hayashi K.
        • Horie N.
        • Suyama K.
        • et al.
        An epidemiological survey of moyamoya disease, unilateral moyamoya disease and quasi-moyamoya disease in Japan.
        Clin Neurol Neurosurg. 2013; 115: 930-933
        • Kim S.S.
        • Park D.H.
        • Lee N.J.
        • et al.
        Coil embolization of a ruptured basilar tip aneurysm associated with bilateral cervical internal carotid artery occlusion: a case report and literature review.
        J Cerebrovasc Endovasc Neurosurg. 2012; 14: 44-49
        • Rabinstein A.A.
        • Romano J.G.
        • Forteza A.M.
        • et al.
        Rapidly progressive dementia due to bilateral internal carotid artery occlusion with infarction of the total length of the corpus callosum.
        J Neuroimaging. 2004; 14: 176-179
        • Shintani S.
        • Tsuruoka S.
        • Shiigai T.
        • et al.
        PET study in bilateral internal carotid artery occlusion.
        Cerebrovasc Dis. 2003; 16: 442-447
        • Thie J.A.
        • Hubner K.F.
        • Smith G.T.
        Model interpretation and clinical implications.
        Clin Positron Imaging. 1999; 2: 99-104
        • Persoon S.
        • Klijn C.J.
        • Algra A.
        • et al.
        Bilateral carotid artery occlusion with transient or moderately disabling ischaemic stroke: clinical features and long-term outcome.
        J Neurol. 2009; 256: 1728-1735
        • Powers W.J.
        • Derdeyn C.P.
        • Fritsch S.M.
        Benign prognosis of never-symptomatic carotid occlusion.
        Neurology. 2000; 54: 878-882
        • Lai S.L.
        • Chen Y.C.
        • Weng H.H.
        • et al.
        Bilateral common carotid artery occlusion–a case report and literature review.
        J Neurol Sci. 2005; 238: 101-104
        • Ter-Akopian A.V.
        • Kalinin A.A.
        • Pankov A.S.
        • et al.
        Stagewise bilateral stenting of vertebral arteries in a patient with occlusion of both internal carotid arteries.
        Angiol Sosud Khir. 2012; 18: 143-146
        • Grubb Jr., R.L.
        • Powers W.J.
        • Clarke W.R.
        • et al.
        Carotid Occlusion Surgery Study Investigators: Surgical results of the Carotid Occlusion Surgery Study.
        J Neurosurg. 2013; 118: 25-33
        • Marshall R.S.
        • Festa J.R.
        • Cheung Y.K.
        • et al.
        • RECON Investigators
        Randomized Evaluation of Carotid Occlusion and Neurocognition (RECON) trial: main results.
        Neurology. 2014; 82: 744-751
        • Romero J.R.
        • Pikula A.
        • Nguyen T.N.
        • et al.
        Cerebral collateral circulation in carotid artery disease.
        Curr Cardiol Rev. 2009; 5: 279-288