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Washington University Experience | VASCULAR | Atherosclerosis | 13A1 Atherosclerosis, Int Carotid (Case 13)
Case 13 History ---- The patient was an 80 year old woman with a history of an old right CVA 4 years prior to her death. She was markedly hypertensive controlled with multiple drugs and a type II diabetic on oral agents only with blood glucose values >400mg%. She was seen at the ER for nausea, vomiting and drowsiness. Workup included a stay in the CCU for chest pain which was negative for MI. The patient developed small fixed pupils, quadriparesis with upgoing toes. She was thought to have a basilar artery occlusion. She continued to deteriorate and expired. ---- Autopsy demonstrated a 1280 gram brain with modest atherosclerosis of the vessels of the circle of Willis; however, there was no flow for either vertebral artery and left internal artery at the bifurcation. An acute infarct of cerebral hemispheres followed a left MCA distribution. In addition, there were remote and subacute lacunar infarcts in the caudate, midbrain and pons. ---- 13A1 This section shows the bifurcation of the left common carotid with complete thrombosis of the internal carotid with a chronic plaque.
