2022 Volume 27 Issue 2 Pages 153-158
We describe a case in which a cardiogenic thrombus at the cervical internal carotid artery migrated to the middle cerebral artery. The patient was a 69‒year‒old female who had mild neurological symptoms. At her first visit, magnetic resonance diffusion‒weighted imaging indicated no acute ischemic lesion. Magnetic resonance angiography revealed occlusion of the right internal carotid artery and a patent middle cerebral artery supplied via the posterior communicating artery. The next day, the patient exhibited left hemiparesis and occlusion of both the internal carotid artery and middle cerebral artery. A mechanical thrombectomy was performed. Complete recanalization was achieved, and the patient’s neurological deficits were resolved. The mechanical thrombectomy was effective for this emergency state of thrombus migration from the cervical internal carotid artery to the terminus of the internal carotid artery. The present case demonstrates that it is possible for a thrombus of the cervical internal carotid artery to migrate to a distal intracranial artery and result in severe symptoms. In the event of such an emergency, a system for rapid treatment by mechanical thrombectomy is needed.
