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

• Published in: Journal of stroke and cerebrovascular diseases 2015-08, Vol.24 (8), p.e201-e204
• Main Authors: Xiong, Zhilin, MD, Lin, Xueying, MD, Bi, Wei, MD, PhD, Li, Wenxian, MD, Jing, Zhen, MD, Huang, Li'an, MD, PhD
• Format: Article
• Language: English
• Subjects: Aged; Cardiovascular; Carotid Artery Diseases - diagnosis; Carotid Artery Diseases - drug therapy; Carotid Artery Diseases - physiopathology; Cerebral Cortex - metabolism; Cerebrovascular Circulation - physiology; Fluorodeoxyglucose F18 - metabolism; Glucose - metabolism; glucose uptake; Humans; Internal carotid artery; Magnetic Resonance Angiography; Magnetic Resonance Imaging; Male; Neurology; occlusion; Platelet Aggregation Inhibitors - therapeutic use; Positron-Emission Tomography
• ISSN: 1052-3057; 1532-8511
• DOI: 10.1016/j.jstrokecerebrovasdis.2015.03.059

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.