[A case of carotid rete mirabile associated with pseudoxanthoma elasticum: a case report]

Abstract

A case of carotid rete mirabile (CRM) with pseudoxanthoma elasticum (PXE) was reported. A 55-year-old woman was admitted to our hospital with complain of left motor weakness. Plain CT scan showed a lacuna in the right internal capsule. Right retrograde brachial angiography and left carotid angiography demonstrated that internal carotid arteries were hypoplastic and winding, and there were abnormal networks between ICA in the cavernous portion and internal maxillary artery, which was a branch of external carotid artery. Diagnosis of CRM was made. Fundoscopy showed bilateral angioid streaks and histological examination of a eruption in her right neck revealed degeneration of elastic fiber and calcium deposits in the derm, which findings were verified to be PXE. So this case was diagnosed of CRM combined with PXE. She got better by conservative therapy in 3 weeks and discharged on foot. On previous literatures 5 cases of CRM were reported and one of which was associated with PXE. CRM is a normal anatomical structure noted lower mammals like cat, sheep and pig. 10% of PXE, which is systemic disorder of elastic fiber, showed CNS lesions. Our case seems to be CRM combined with PXE by chance. But two of 6 cases of CRM were with PXE, so it is necessary that a case of PXE should be examined angiographically.