Vascular Reconstruction for Radiation-induced Bilateral Internal Carotid Artery Occlusion and Unilateral External Carotid Artery Stenosis by a Combination of Surgical and Endovascular Method: Case Report.

Autor:	Taki J; Department of Neurosurgery, Tenri Hospital, Tenri, Nara., Tokime T; Department of Neurosurgery, Tenri Hospital, Tenri, Nara., Matsumoto A; Department of Neurosurgery, Tenri Hospital, Tenri, Nara., Akiyama Y; Department of Neurosurgery, Tenri Hospital, Tenri, Nara.
Jazyk:	angličtina
Zdroj:	NMC case report journal [NMC Case Rep J] 2014 Dec 06; Vol. 2 (1), pp. 16-20. Date of Electronic Publication: 2014 Dec 06 (Print Publication: 2015).
DOI:	10.2176/nmccrj.2014-0154
Abstrakt:	We present a case of a 63-year-old male presenting with right hemiparesis and diagnosed as cerebral infarction. He had a previous history of left pharyngeal carcinoma, which was treated by radial dissection and radiation therapy 10 years before. Magnetic resonance imaging (MRI) showed multiple cerebral infarction in the bilateral cerebral hemisphere, predominantly on the left. Cerebral angiography showed occlusion of bilateral internal carotid arteries and severe stenosis at the orifice of the left external carotid artery (ECA). Single photon emission tomography (SPECT) showed reduced cerebral blood flow and decreased cerebral vascular reserve in the bilateral anterior cerebral artery and left middle cerebral artery territories. He was successfully treated by a combination of carotid stenting for the left ECA and left superficial temporal artery-middle cerebral artery (STA-MCA) anastomosis. He did not have further ischemic symptom for more than 2 years. Radiation-induced carotid vasculopathy often involves multiple arteries and treatment is often complex and difficult. Safer and less invasive treatment strategy should be considered using both endovascular and direct surgery. Competing Interests: Conflicts of Interest Disclosure The authors report no conflict of interest concerning the case presented in this article.
Databáze:	MEDLINE
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