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Successful Treatment by Emergency Carotid Endarterectomy

Arch Neurol. 2002;59:1484-1485.

	Since this article does not have an abstract, we have provided the first 150 words of the full text and any section headings.

A 28-YEAR-OLD MAN had sudden-onset motor aphasia, progressive somnolence, and right-sided motor hemiparesis 3 hours after intense soccer playing. On admission to our neurology department 1 hour after symptom onset, the results of a computed tomographic scan were normal, and duplex ultrasonography showed a partially occluding thrombus (Figure 1), extending from the left carotid bifurcation 3 cm into the internal carotid artery. Clinically, the patient's somnolence and right-sided hemiparesis worsened, and he underwent immediate thromboendarterectomy in the Department of Vascular Surgery, Technical University of Munich, Munich, Germany.

Figure appears in full text version. Figure 1. A transverse ultrasonogram shows a partially occluding thrombus (arrowheads) extending from the left carotid bifurcation 3 cm into the internal carotid artery.

Intraoperatively, a soft, pliable thrombus adhering to a ruptured, lipid-rich atherosclerotic plaque was found. Histological examination revealed intraplaque thrombus formation at the rupture site, granulation tissue with chronic inflammatory cell infiltrates, and fibrotic intimal thickening (Figure . . . [Full Text of this Article]

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