Rinsho Shinkeigaku (Clinical Neurology)

Brief Clinical Note

Ineffective thrombolytic therapy for calcified cerebral emboli originated from calcified internal carotid artery stenosis

Shuhei Okazaki, M.D.1), Manabu Sakaguchi, M.D.2), Yukio Sugiyama, M.D.1), Hiroshi Ooe, M.D.1), Kazuo Kitagawa, M.D.1) and Saburo Sakoda, M.D.1)

1)Department of Neurology, Osaka University Hospital
2)Stroke Center, Osaka University Hospital

We report a 71-year-old man who presented with acute right hemiparesis and aphasia. The admission CT and CT angiogram showed multiple small calcified emboli in branches of the left middle cerebral artery. The patient had shown no sign of improvement after intravenous thrombolytic therapy. Follow-up CT indicated acute multiple infarctions in the left middle cerebral artery area coincident with the calcified emboli. Carotid duplex sonography and cervical CT angiogram showed calcified plaque with ulceration at the origin of left internal carotid artery, which is the origin of those emboli. Since calcified cerebral emboli (CCE) are rare, it should be further investigated if intravenous thrombolysis is effective in CCE.
Full Text of this Article in Japanese PDF (523K)

(CLINICA NEUROL, 49: 281|284, 2009)
key words: brain infarction, carotid stenosis, thrombolytic therapy, tissue plasminogen activator, calcified cerebral emboli

(Received: 9-Feb-09)