RT Journal Article
SR Electronic
T1 Facing the crossroads: acute stroke with bilateral carotid occlusion
JF BMJ Case Reports
JO BMJ Case Reports
FD BMJ Publishing Group Ltd
SP e229638
DO 10.1136/bcr-2019-229638
VO 12
IS 6
A1 Guilherme Jose Agnoletto
A1 Manuel F Granja
A1 Ricardo Hanel
A1 Amin Aghaebrahim
YR 2019
UL http://casereports.bmj.com/content/12/6/e229638.abstract
AB We present a previously unreported case of endovascular therapy in the acute setting of ischaemic stroke in a patient with bilateral carotid occlusion (BCO). A 54-year-old man presents with sudden onset of right-sided weakness, difficulty speaking and left-sided gaze, with National Institute of Health Stroke Scale of 22 and no abnormalities on plain CT head. CT angiography showed BCO and CT perfusion demonstrated extensive area of penumbra in both hemispheres. The patient was sent for cerebral angiography that confirmed BCO. Since symptomatology was a left middle cerebral arteries syndrome, decision was made to angioplasty and stent the left internal carotid artery emergently, which was performed successfully and the patient had complete resolution of symptoms. Acute stroke with BCO represents a challenge in decision making regarding acute management and individual assessment must be made.