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• Vol.54 No.11
• CLINICA NEUROL, 54: 916−919, 2014
• Vol.54 No.11 contents

Brief Clinical Note

Effective thrombolytic therapy for calcified cerebral embolism originating from a calcified plaque in the internal carotid artery

Naohiko Seike, M.D.¹⁾⁴⁾, Keigo Matsumoto, M.D., Ph.D.²⁾, Yushi Hirota, M.D., Ph.D.³⁾ and Hiroshi Kobessho, M.D., Ph.D.¹⁾

¹⁾Department of Neurology, JCHO Kobe Central Hospital
²⁾Department of Neurosurgery, JCHO Kobe Central Hospital
³⁾Division of Diabetes and Endocrinology, The Department of Internal Medicine Kobe University Hospital
⁴⁾Present Address: Division of Neurology, Kobe University Graduate School of Medicine/Department of Pathology, Brain Research Institute, Niigata University

A 72-year-old man was transported to our emergency department after rear-ending another vehicle. He presented with acute left hemispatial neglect, left hemianopsia, and mild left hemiparesis. Computed tomography (CT) on admission showed a calcified embolus in the right middle cerebral artery. After intravenous thrombolytic therapy, the patient showed drastic improvement of neurological deficits. Follow-up CT showed disappearance of embolus, but distal migration of emboli to the downstream of the right middle cerebral artery was seen, sparing the massive territory of the right middle cerebral artery. Carotid duplex sonography and 3-dimensional CT angiography showed a calcified plaque with ulceration at the origin of the right internal carotid artery, representing the presumptive origin of the emboli. We report a rare case of effective intravenous thrombolysis for calcified cerebral embolism from the carotid artery. Further consideration of the mechanism, efficacy, and indication of intravenous thrombolysis for calcified cerebral emboli is needed.
Full Text of this Article in Japanese PDF (3283K)

(CLINICA NEUROL, 54: 916−919, 2014)
key words: brain infarction, calcified carotid plaque, thrombolytic therapy, tissue plasminogen activator, calcified cerebral embolism

(Received: 26-Mar-14)