Department of Neurological Surgery, Juntendo University Urayasu Hospital, 2-1-1 Tomioka, Urayasu, Chiba, 279-0021, Japan.
Department of Neurosurgery, Koshigaya Municipal Hospital, Koshigaya, Saitama, Japan.
Surg Radiol Anat. 2024 Jun;46(6):891-893. doi: 10.1007/s00276-024-03362-5. Epub 2024 Apr 23.
The superior thyroid cornu (STC) is a normal anatomic structure that forms part of the thyroid cartilage. Here, we report a patient with unusually elongated and ossified STC that might result in recurrent cerebral embolisms. During a second endovascular therapy for recurrent middle cerebral artery embolism, a segment with an irregular filling defect was noted in the internal carotid artery (ICA), at the C1 level. This defect was unnoticed during the initial endovascular procedure. Three-dimensional computed tomography angiography performed after the second endovascular procedure revealed an ICA segment located between the STC and C1 with a tortuous course and irregular wall of the ICA. Therefore, we assumed that STC compression of the ICA could have resulted in thrombus formation at the site and consequent cerebral embolism. The STC should be considered a structure responsible for cerebral embolism. Careful evaluation of the entire ICA course is imperative prior to performing an endovascular thrombectomy for acute embolic occlusion of the middle cerebral artery.
甲状软骨上角（STC）是正常的解剖结构，构成甲状软骨的一部分。在此，我们报告一例 STC 异常延长和骨化的患者，可能导致反复脑栓塞。在第二次因大脑中动脉栓塞复发而行血管内治疗时，在颈内动脉（ICA）C1 水平段发现一处不规则充盈缺损。在初次血管内治疗过程中未注意到这一缺损。第二次血管内治疗后行三维 CT 血管造影显示，ICA 位于 STC 和 C1 之间的一段呈迂曲走行，且 ICA 壁不规则。因此，我们推测 STC 对 ICA 的压迫可能导致该部位血栓形成和随后的脑栓塞。STC 应被视为引起脑栓塞的结构。在对大脑中动脉急性栓塞行血管内血栓切除术之前，必须仔细评估整个 ICA 走行。
