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• Vol.63 No.6
• CLINICA NEUROL, 63: 369−374, 2023
• Vol.63 No.6 contents

Case Report

Internal carotid artery stenosis with repeated ischemic stroke recurrence due to mechanical stimulation by the hyoid bone and thyroid cartilage: a case e report

Fumiya Kutsuna, M.D.¹⁾, Ichiro Kawahara, M.D., Ph.D.²⁾, Fujinobu Tanaka, M.D., Ph.D.³⁾, Eisaku Sadakata, M.D., Ph.D.²⁾, Wataru Haraguchi, M.D., Ph.D.²⁾ and Hiroshi Iwanaga, M.D., Ph.D.¹⁾

¹⁾ Department of Neurology, National Hospital Organization Nagasaki Medical Center
²⁾ Department of Neurosurgery, National Hospital Organization Nagasaki Medical Center
³⁾ Department of Otorhinolaryngology, National Hospital Organization Nagasaki Medical Center

We present a case of internal carotid artery (ICA) stenosis caused by mechanical stimulation by the hyoid bone (HB) and thyroid cartilage (TC). A 78-year-old man with a history of right ICA stenting four years previously was admitted for abrupt onset of dysarthria and left hemiparesis and diagnosed with ischemic stroke by magnetic resonance imaging. Three-dimensional computed tomographic angiography revealed internal carotid in-stent restenosis. Furthermore, the HB and TC contacted with the right ICA. Treatment involved antiplatelet therapy, partial HB and TC resection, and carotid artery restenting. Posttreatmently, the ICA was restored and stenosis improved. Since restenosis may occur posttreatmently in patients with carotid artery stenosis caused by mechanical stimulation of the HB and TC, it is necessary to consider treatments including not only carotid artery stenting but also partial bone structures resection and carotid endarterectomy.
Full Text of this Article in Japanese PDF (3665K)

(CLINICA NEUROL, 63: 369−374, 2023)
key words: carotid artery stenosis, carotid artery stenting, hyoid bone, ischemic stroke, thyroid cartilage

(Received: 22-Feb-23)