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

J Stroke Cerebrovasc Dis. 2015 Aug;24(8):e201-4. doi: 10.1016/j.jstrokecerebrovasdis.2015.03.059. Epub 2015 Jun 16.

Abstract

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.

Keywords: Internal carotid artery; glucose uptake; occlusion.

Publication types

  • Case Reports

MeSH terms

  • Aged
  • Carotid Artery Diseases / diagnosis*
  • Carotid Artery Diseases / drug therapy
  • Carotid Artery Diseases / physiopathology*
  • Cerebral Cortex / metabolism
  • Cerebrovascular Circulation / physiology*
  • Fluorodeoxyglucose F18 / metabolism
  • Glucose / metabolism*
  • Humans
  • Magnetic Resonance Angiography
  • Magnetic Resonance Imaging
  • Male
  • Platelet Aggregation Inhibitors / therapeutic use
  • Positron-Emission Tomography

Substances

  • Platelet Aggregation Inhibitors
  • Fluorodeoxyglucose F18
  • Glucose