Life-threatening bilateral internal carotid artery and unilateral vertebral artery total occlusion presenting with dizziness: a case report
- PMID: 39238975
- PMCID: PMC11374277
- DOI: 10.1097/MS9.0000000000002346
Life-threatening bilateral internal carotid artery and unilateral vertebral artery total occlusion presenting with dizziness: a case report
Abstract
Introduction: It is well known that whereas bilateral occlusion is less common, unilateral internal carotid artery blockage happens regularly. Asymptomatic to fatal ischemic stroke can be the clinical presentation, depending on whether there is adequate collateral blood flow. Internal carotid artery occlusion is often associated with significant neurologic events, both at the time of initial occlusion and during follow-up.
Case presentation: The authors describe a patient's experience of dizziness followed by a fall. The hyperdense position of the basilar artery near its bifurcation was identified following a computed tomography (CT) scan. Furthermore, the pons, midbrain, and medial parts of the right temporal lobe showed numerous small hypodensities suggestive of an ischemic injury. The patient had medical treatment without surgery after it was determined that they had bilateral internal carotid arteries and a blocked right vertebral artery. After taking dual anti-platelet therapy for 5 days, the patient recovered without incident and was discharged from the hospital.
Discussion: In a young patient with bilateral internal carotid arteries occlusion (BICAO), the authors highlighted the significance of prompt diagnosis of stroke-like symptoms, diagnostic possibilities, and treatment options. Options for diagnosis include brain MRI and CT head to check for ischemia and CT angiography (CTA) head and neck to assess for artery obstruction. Options for treatment include severe medical and surgical treatments, such as carotid endarterectomy, stent implantation, or balloon angioplasty, or medical management alone, such as dual anti-platelet medication and thrombolysis.
Conclusion: BICAO is associated with a grave prognosis and significant cerebrovascular complications. High-quality studies are needed to establish the best treatment strategy, considering the complex and individualized nature of the condition.
Keywords: bilateral internal carotid arteries; case report; dizziness; stroke; unilateral; vertebral artery occlusion.
Copyright © 2024 The Author(s). Published by Wolters Kluwer Health, Inc.
Conflict of interest statement
There is no conflict of interest to declare.Sponsorships or competing interests that may be relevant to content are disclosed at the end of this article.
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References
-
- AbuRahma A, Copeland SE. Bilateral internal carotid artery occlusion: natural history and surgical alternatives. Cardiovasc Surg 1998;6:579–83. - PubMed
-
- Doshi M, Muley A, Kumar S, et al. . A case of bilateral internal carotid artery complete occlusion. J Integr Health Sci 2019;7:65–68.
-
- Faught WE, van Bemmelen PS, Mattos MA, et al. . Presentation and natural history of internal carotid artery occlusion. J Vasc Surg 1993;18:512–23; discussion 524. - PubMed
-
- Friedman SG, Lamparello PJ, Riles TS, et al. . Surgical management of the patient with bilateral internal carotid artery occlusion. J Vasc Surg 1987;5:715–8. - PubMed
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