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Washington University Experience | VASCULAR | Infarct - Acute | 11A0 Case 11 History
Case 11 History ---- The patient was a 67 year old diabetic man with a fixed deficit that improved briefly and had superimposed transient deficits intermittently. Symptoms were related to both cerebral hemispheres. Angiography revealed a completely occluded left internal carotid with stenosis of the right side. He underwent a right carotid endarterectomy with indwelling shunt, but never regained useful neurological function post-operatively. His deterioration was suggestive of herniation and he expired approximately 34 hours post-operatively. ---- At autopsy, thrombosis of the right internal carotid artery and right anterior cerebral artery were accompanied by extensive acute infarction in the distribution of the right middle and anterior cerebral arteries resulting in herniation of the right cingulate gyrus and uncal gyri with secondary brain stem hemorrhages.
