2019 Volume 41 Issue 5 Pages 399-403
Introduction: Calcified plaque in the carotid artery is considered less likely to cause embolization than soft plaque. We used carotid endarterectomy (CEA) to treat a patient who developed repeated cerebral infarctions during a short space of time and was diagnosed with calcified cerebral emboli (CCE) resulting from carotid calcifications on the basis of test results. Case Report: A 69-year-old man was admitted after transient ischemic attacks. He was treated with antiplatelet therapy and his condition was subsequently monitored. He suffered from repeated cerebral infarctions five times during an approximately 4-month period after the initial hospitalization. Tests ruled out cardiogenic and aortogenic infarctions, and severely calcified lesions in the internal carotid artery in the right neck were considered as the cause. Although only mild stenosis was present, CEA was performed to prevent further recurrence of cerebral infarction. Results: Intraoperative examination revealed a localized protrusion into the carotid artery lumen of calcified lesions similar to grains of sand. The patient was discharged home with a modified Rankin Scale score of 1. The course has been uneventful, without any signs of recurrence. Discussion/Conclusion: We performed CEA to treat a patient diagnosed with CCE after repeated cerebral infarction. Few reports have described CCE; some cases have been described as a complication of aortic lesions, valvular disease, or surgery, and others as caused by carotid calcifications as described in this report. CEA should be considered for patients with CCE who are resistant to medical treatment and develop repeated cerebral infarctions.
