Karki Monika, Devarakonda Pradeep Kumar, Dhulipalla Lohitha, Pattipati Meghana, Ayala-Rodriguez Cesar
Internal Medicine, The Brooklyn Hospital Center, Brooklyn, USA.
Cardiology, The Brooklyn Hospital Center - Mount Sinai Heart, Brooklyn, USA.
Cureus. 2021 Jun 27;13(6):e15971. doi: 10.7759/cureus.15971. eCollection 2021 Jun.
Bilateral internal carotid artery occlusion (BICAO) is a rare disease leading to serious cerebrovascular disease and complications including recurrent ischemic stroke or death. There are very few cases reported on BICAO, especially among young adults. The clinical presentation can range from asymptomatic to fatal ischemic stroke depending upon the presence of adequate collateral blood flow. Here we report a case of BICAO in a 31-year-old female who presented with intermittent left-sided hemiparesis for one day and was subsequently found to have complete occlusion of the bilateral intracranial internal carotid arteries on CT angiography (CTA). Magnetic resonance imaging (MRI) brain showed sub-acute right middle cerebral artery (MCA), acute left middle cerebral artery, and anterior cerebral artery infarcts (ACA). Being outside the window for thrombolysis, she was successfully treated with balloon angioplasty of the left internal carotid artery (ICA) and started on dual antiplatelet therapy. The case illustrates the importance of evaluating for cerebrovascular disease when someone presents with stroke-like symptoms even in the young adult population, as prompt treatment can be lifesaving.
双侧颈内动脉闭塞（BICAO）是一种罕见疾病，可导致严重的脑血管疾病及包括复发性缺血性卒中或死亡在内的并发症。关于BICAO的病例报道极少，尤其是在年轻成年人中。临床表现因是否存在充足的侧支血流而异，从无症状到致命性缺血性卒中不等。在此，我们报告一例31岁女性的BICAO病例，该患者出现间歇性左侧偏瘫1天，随后在CT血管造影（CTA）检查中发现双侧颅内颈内动脉完全闭塞。脑部磁共振成像（MRI）显示右大脑中动脉（MCA）亚急性梗死、左大脑中动脉急性梗死以及大脑前动脉（ACA）梗死。由于已过溶栓时间窗，她接受了左侧颈内动脉（ICA）球囊血管成形术治疗并成功治愈，随后开始双联抗血小板治疗。该病例表明，即使在年轻成年人群中，当有人出现类似卒中症状时，评估脑血管疾病非常重要，因为及时治疗可挽救生命。
