1/9. cerebral hemorrhage after systemic fibrinolysis in a patient with severe carotid artery stenosis.Despite the beneficial effect of systemic fibrinolysis in treatment within 3 hours from ischemic stroke onset, the unpredicted occurrence of intracerebral hemorrhage remains a risk from such therapy. Few data exist defining patients at risk for this outcome. We report clinical and neuropathological data on a patient fulfilling NINDS rt-PA study and ECASS-2 inclusion criteria with an acute stroke due to high-grade carotid artery stenosis and preceded by amaurosis fugax. He died from an intracerebral hemorrhage after systemic fibrinolysis. The fatal outcome adds support to recommendations that rapid Doppler-sonographic evaluation of the extra- and intracranial vascular status be undertaken before systemic rt-PA is implemented in acute ischemic stroke.- - - - - - - - - - ranking = 1keywords = carotid artery, carotid, artery (Clic here for more details about this article) |
2/9. Transient global amnesia and amaurosis fugax in a patient with common carotid artery occlusion--a case report.The etiology of transient global amnesia (TGA) is debatable. The hypothesis of a thromboembolic cause of TGA has been questioned by recent case control studies. Occlusion of the common carotid artery (CCA) is rare. Although amaurosis fugax (AF) is a hallmark of ipsilateral internal carotid artery disease, its occurrence in CCA occlusion is less known. association of these three conditions in a patient may imply pathophysiologic significance. Here, the authors report a 76-year-old man who suffered from a spell of TGA and then several attacks of AF of the right eye. Progressive occlusion of the right CCA was documented by repeat carotid duplex scans and was finally confirmed by cerebral angiography. In this patient, the occurrence of CCA occlusion and AF implicates a vascular etiology for the event of TGA. A noninvasive carotid ultrasonographic screen may, therefore, be worthwhile for patients with TGA.- - - - - - - - - - ranking = 2.4596243258352keywords = carotid artery, carotid, artery (Clic here for more details about this article) |
3/9. Delayed onset of amaurosis fugax in a patient with type A aortic dissection post surgical repair.stroke is an important complication for the surgical treatment of type A aortic dissection and it occurs immediately post operation. Many surgical techniques such as deep hypothermic circulatory arrest and retrograde cerebral perfusion have been reported to ameliorate this complication. We report here a male Taiwanese patient with type A aortic dissection involving the arch who underwent surgical repair. amaurosis fugax appeared on the 4th day post operation. Funduscopic findings demonstrated multi focal embolization and carotid sonography revealed normal carotid arteries. The symptoms and signs improved after anticoagulation therapy. This is a rare case of delayed onset of amaurosis fugax in a patient with type A aortic dissection post surgical repair. The thromboemboli might have originated from the internal surface of the sawing area.- - - - - - - - - - ranking = 0.31155418093786keywords = carotid (Clic here for more details about this article) |
4/9. light-induced amaurosis fugax.PURPOSE: To describe an important symptom of bilateral amaurosis precipitated by exposure to bright light. methods: Case report. Clinical analysis of transient, painless, asymmetrical visual loss occurring in bright light in a 54-year-old man. RESULTS: Carotid ultrasound showed bilateral carotid disease. Carotid angiography demonstrated occlusion of the left internal carotid artery and severe stenosis of the right internal carotid artery and both external carotid arteries. Visual symptoms and an abnormal photostress test completely remitted after a right carotid endarterectomy. CONCLUSION: light-induced amaurosis is an unfamiliar manifestation of ocular ischemic syndrome occurring with severe, often bilateral, carotid artery disease. Its recognition is important because the complaint is associated with severe carotid occlusive disease and recognition is necessary for timely surgical intervention because of the major risk for stroke.- - - - - - - - - - ranking = 1.6971434343244keywords = carotid artery, carotid, artery (Clic here for more details about this article) |
5/9. amaurosis fugax and stenosis of the ophthalmic artery--a case report.amaurosis fugax has many causes. Its most common cause is transient hypoperfusion of the eye, caused by thromboemboli from atherosclerotic carotid arteries. thromboembolism from carotid arteries is a risk factor for cerebral infarction, and preventive endarterectomy could be performed. This report describes a patient with a rare ophthalmic artery stenosis, which was the probable origin of thromboemboli. This finding prevented surgical intervention.- - - - - - - - - - ranking = 0.33515411507293keywords = carotid, artery (Clic here for more details about this article) |
6/9. Importance of jugular valve incompetence in contrast transcranial Doppler ultrasonography for the diagnosis of patent foramen ovale.Transcranial Doppler (TCD) ultrasound with the intravenous injection of agitated saline as contrast (cTCD) is an effective method for detecting right-to-left intracardiac and extracardiac shunt (RLS); however, the sensitivity of cTCD in the diagnosis of RLS remains slightly less than that of transesophageal echocardiography, even in patients with adequate transtemporal ultrasonic bone windows. The authors present a case with cTCD underestimating RLS because of jugular valve incompetence in a 42-year-old man presenting with an episode of transient aphasia. Three weeks after transcatheter closure of a patent foramen ovale associated with an atrial septal aneurysm, he experienced 2 episodes of amaurosis fugax. Following a negative 45-minute embolus detection study with power M-mode TCD, the patient underwent a cTCD study with monitoring of the left middle cerebral artery (MCA), the anterior cerebral artery, and the submandibular extracranial internal carotid artery. A single microbubble (MB) was detected in the left MCA in only 1 of 5 studies; the remaining runs all failed to detect an RLS. Significant MB reflux was noted in the left internal jugular vein because of jugular valve incompetence. The authors conclude that incompetence of the jugular vein valve can result in a false negative cTCD study for RLS detection.- - - - - - - - - - ranking = 0.36745166447025keywords = carotid artery, carotid, artery (Clic here for more details about this article) |
7/9. diabetic retinopathy with repeated amaurosis fugax caused by orthostatic hypotension.PURPOSE: To evaluate the blood flow velocity in the ophthalmic artery using color Doppler imaging in two patients who had diabetic retinopathy with amaurosis fugax caused by orthostatic hypotension. DESIGN: Interventional case reports. methods: A 40-year-old woman (Case 1) and a 65-year-old man (Case 2) had diabetic retinopathy and amaurosis fugax caused by orthostatic hypotension. We evaluated the blood flow velocity in the ophthalmic artery using color Doppler imaging in the two patients. SETTING: Department of ophthalmology, Diabetes Center tokyo women's Medical University, tokyo, japan. RESULTS: For Case 1, the maximum systolic blood flow velocity in the ophthalmic artery (V max) was 10 cm/sec in the supine position. In a seated position, visual acuity was decreased from 20/20 to light perception as V max fell to 1 cm/sec. For Case 2, the V max was 14 cm/sec in the supine position, but it was too low to measure in a seated position. CONCLUSIONS: The decrease of V max by orthostatic hypotension may cause amaurosis fugax in patients with diabetic retinopathy.- - - - - - - - - - ranking = 0.014159960481041keywords = artery (Clic here for more details about this article) |
8/9. A case of frequently recurring amaurosis fugax with atherothrombotic ophthalmic artery occlusion.A 49-year-old woman with diabetes mellitus and hyperlipidemia experienced frequent transient monocular blindness in the right eye during a 3-week period. Examination revealed atherothrombotic occlusion of the right ophthalmic artery (OA) without embolic sources. After treatment with aspirin, attacks resolved completely. Her symptoms were attributed to microembolism from the occluded OA.- - - - - - - - - - ranking = 0.023599934135068keywords = artery (Clic here for more details about this article) |
9/9. sirolimus-eluting stenting of the external carotid artery for the treatment of ocular ischemia.PURPOSE: To present a patient in whom severe external carotid artery (ECA) stenosis causing ocular ischemia was treated with a drug-eluting stent. CASE REPORT: A 55-year-old woman with severe, diffuse atherosclerosis presented with impaired left ocular perfusion and amaurosis fugax. Duplex ultrasonography and angiography documented bilateral occlusion at the origin of the internal carotid arteries, bilateral subtotal ECA stenoses, and subtotal distal left common carotid artery (CCA) restenosis following endarterectomy. Percutaneous revascularization of the left ECA and CCA stenoses was performed using a short coronary balloon-expandable sirolimus-eluting stent and a self-expanding nitinol stent, respectively. The procedure was uneventful, and the ocular symptoms resolved. At 6 months, the patient remained asymptomatic, with angiographically patent stents. CONCLUSION: Drug-eluting stenting may be a novel option to treat symptomatic ECA stenosis.- - - - - - - - - - ranking = 2.3038472353663keywords = carotid artery, carotid, artery (Clic here for more details about this article) |