Carotid artery web with fetal posterior cerebral artery variant masquerading as recurrent ipsilateral cryptogenic ischaemic strokes

A 31-year-old woman was referred to vascular surgeons with the history of recurrent ischaemic strokes in two cerebral artery territories over a span of 1 year. On investigation, she was found to have a right internal carotid artery web, with thrombus and a fetal right posterior cerebral artery (PCA)...

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Bibliographic Details
Published in:BMJ case reports 2021-12, Vol.14 (12), p.e246421
Main Authors: Mehra, Rohit, Patra, Vikram, Dhillan, Rishi
Format: Article
Language:English
Subjects:
Adult
Angioplasty
Blood clots
Brain Ischemia - diagnostic imaging
Brain Ischemia - etiology
Carotid Arteries
Carotid Artery, Internal - diagnostic imaging
Carotid Artery, Internal - surgery
Carotid Stenosis
Case reports
Endarterectomy, Carotid
Female
Humans
Ischemia
Ischemic Stroke
Medical imaging
Migraine
Posterior Cerebral Artery - diagnostic imaging
Posterior Cerebral Artery - surgery
Postoperative period
Stents
Stroke
Stroke - etiology
Surgeons
Veins & arteries
Citations: Items that this one cites
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Summary:A 31-year-old woman was referred to vascular surgeons with the history of recurrent ischaemic strokes in two cerebral artery territories over a span of 1 year. On investigation, she was found to have a right internal carotid artery web, with thrombus and a fetal right posterior cerebral artery (PCA), which explained the ischaemic strokes in right middle cerebral and PCA territory. The rare association of these two infrequent entities makes the case a singular one in the medical literature. Successful surgical excision was done after multidisciplinary teamwork. The carotid web was excised as part of carotid artery endarterectomy and repaired with great saphenous vein patch angioplasty. The patient made a good recovery.
ISSN:1757-790X
1757-790X
DOI:10.1136/bcr-2021-246421